Abstract
Dysuria and/or hematuria are common and worrisome symptoms for most parents. Dysuria results from excessive bladder muscle contraction and peristaltic activity of the edematous and inflamed urethral mucosa. Though urinary tract infection remains the commonest cause for dysuria, non-infectious causes should also be kept in mind. Equating all cases of dysuria to urinary infection is not incorrect. Hematuria can be both macroscopic and microscopic and an important sign of genitourinary tract disease. However, systemic causes like bleeding disorder or malignancy can also present with hematuria. A thorough history and physical examination is important for arriving at a diagnosis. The investigations for both the symptoms and the urgency with which the tests are required are dictated by the patient’s clinical presentation.
Similar content being viewed by others
References
Warren JW, Abrutyn E, Hebel JR, Johnson JR, Schaeffer AJ, Stamm WE. Guidelines for antimicrobial treatment of ucncomplicated acute bacterial cystitis and acute pyelonephritis in women. Clin Infect Dis. 1999;29:745–58.
Demetriou E, Emans SJMRJ. Dysuria in adolescent girls: urinary tract infection or vaginitis? Pediatrics. 1982;70:299–301.
Koff SA, Wagner TT, Jayanthi VR. The relationship among dysfunctional elimination syndromes, primary vesicoureteral reflux and urinary tract infections in children. J Urol. 1998;160:1019–22.
Wein AJ, Kavoussi LR, Novick AC, et al. Campbell-Walsh Urology. 10th ed. Epub ahead of print 2012. doi: 10.1016/B978-1-4160-6911-9.00061-X.
Michels TC, Sands JE. Dysuria: evaluation and differential diagnosis in adults. Am Fam Physician. 2015;92:778–86.
White B, Oregon Health and Science University, Portland O. Diagnosis and treatment of urinary tract infections in children. Am Fam Phys. 2011; Feb: 409–15
Zamir G, Sakran W, Horowitz Y, et al. Urinary tract infection: is there a need for routine renal ultrasonography? Arch Dis Child. 2004;89:466–8.
Ingelfinger JR, Davis AE, Grupe WE. Frequency and etiology of gross hematuria in a general pediatric setting. Pediatrics. 1977;59:557–61.
Phadke KD. Vijayakumar M, Sharma J, Iyengar A; Indian Pediatric Nephrology Group. Consensus statement on evaluation of gross hematuria. Indian Pediatr. 2006;43:965–73.
Pan CG. Evaluation of gross hematuria. Pediatr Clin N Am. 2006;53:401–12.
Vehaskari VM, Rapola J, Koskimies O, et al. Microscopic hematuria in school children: epidemiology and clinicopathologic evaluation. J Pediatr. 1979;95:676–84.
Dodge WF, West EF, Smith EH, Bruce Harvey 3rd. Proteinuria and hematuria in schoolchildren: epidemiology and early natural history. J Pediatr. 1976;88:327–47.
Youn T, Trachtman H, Gauthier B. Clinical spectrum of gross hematuria in pediatric patients. Clin Pediatr (Phila). 2006;45:135–41.
Meyers KC. Evaluation of hematuria in children. Urol Clin N Am. 2004;31:559–73.
Patel HP, Bissler JJ. Hematuria in children. Pediatr Clin North Am. 2001;48:1519–37.
American Academy of Pediatrics. Urinary tract infections: clinical practice guidelines for the diagnosis and management of initial UTI in febrile infants and children 2 to 24 months. Pediatrics. 2011;128:595–610.
Indian Society of Pediatric Nephrology Group. Indian Academy of Pediatrics. Consensus statement on management of urinary tract infection. Indian Pediatr. 2011;48:709–17.
Author information
Authors and Affiliations
Contributions
VW and BP had done the literature search and drafted the manuscript. AM had guided the framework of the manuscript and had done a critical review and had approved the version to be published. Dr. Muralidharan Jayashree will act as guarantor for this paper.
Corresponding author
Ethics declarations
Conflict of Interest
None.
Source of Funding
None.
Rights and permissions
About this article
Cite this article
Mehta, A., Williams, V. & Parajuli, B. Child with Dysuria and/or Hematuria. Indian J Pediatr 84, 792–798 (2017). https://doi.org/10.1007/s12098-017-2448-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12098-017-2448-4