title: Behavioral and functional abnormalities linked with recurrent urinary tract infections in girls.
abstract: BACKGROUND
  Most girls with recurrent urinary tract infections do not have major urinary tract abnormalities. Recent studies focus on predisposing behavioral and functional abnormalities: infrequent voiding, inadequate fluid intake, stool retention, poor genital hygiene and voiding dysfunction.
  
  
  METHODS
  Complete history, bladder and bowel questionnaire, physical examination, voiding-drinking diary, sonography and uroflowmetry were used to assess infrequent voiding, functional stool retention, poor fluid intake, inadequate hygiene, or voiding dysfunction in girls referred for evaluation of three or more symptomatic urinary tract infections (with a first infection at the age of more than 36 months).
  
  
  RESULTS
  A total of 141 girls aged 3.9 to 18 years were evaluated between 1996 and 1999; 212 abnormalities were noted in 120 patients: infrequent voiding (isolated, 16; combined with other abnormalities, 47), poor fluid intake (isolated, 10; combined, 50), functional stool retention (isolated, 5; combined, 25), inadequate hygiene or toilet habits (isolated, 3; combined, 24), dysfunctional voiding (isolated, 15; combined, 10), bladder overactivity (isolated, 5; combined, 2).
  
  
  CONCLUSIONS
  Most girls referred for evaluation of three or more urinary tract infections have host-mediated predisposing abnormalities: infrequent voiding, poor fluid intake, functional stool retention or voiding dysfunction. Poor genital hygiene and toilet habits were almost always combined with other abnormalities, suggesting that infections are not necessarily related to poor genital hygiene or toilet habits. Two or more indications of predisposing behavior often concur in the same patient.
authors.affiliation: Department of Pediatrics, University Hospital, Berne, Switzerland.
authors.forename: Brunello L
authors.initials: BL
authors.lastname: Mazzola
authors.forename: Rodo O
authors.initials: RO
authors.lastname: von Vigier
authors.forename: Sabine
authors.initials: S
authors.lastname: Marchand
authors.forename: Martin
authors.initials: M
authors.lastname: Tönz
authors.forename: Mario G
authors.initials: MG
authors.lastname: Bianchetti
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D015984:Causality; D002648:Child; D002652:Child Behavior; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D011379:Prognosis; D012008:Recurrence; D012307:Risk Factors; D012720:Severity of Illness Index; D018434:Sickness Impact Profile; D013315:Stress, Psychological; D011795:Surveys and Questionnaires; D013557:Switzerland / Q000453:epidemiology; D016482:Urinalysis; D014552:Urinary Tract Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*; D014555:Urination Disorders / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D014563:Urodynamics; D014718:Vesico-Ureteral Reflux / Q000150:complications* / Q000175:diagnosis