April 1988

Frequent Urinary Tract Infections in Girls

Author Affiliations

Department of Pediatrics University of California-Davis School of Medicine Davis, CA 95616
Department of Psychiatry Columbia University College of Physicians & Surgeons 37 Claudet Way Eastchester, NY 10709
Department of Social Services Babies Hospital Columbia-Presbyterian Medical Center New York, NY 10032
Department of Neuro-Psychology Neurologic Institute Columbia-Presbyterian Medical Center New York, NY 10032

Am J Dis Child. 1988;142(4):412-413. doi:10.1001/archpedi.1988.02150040062004

Sir.—It is well known that bacterial colonization of the bladder is facilitated whenever vesical emptying is incomplete, be it from vesicoureteral reflux, residual urine, or infrequent voiding.1 It has also long been known that psychological conflict can be expressed by infrequent voiding.2 Retention of urine (and stool) may be a passive-aggressive adaptation made by stressed, overwhelmed, and anxious children.3

Bauer and coworkers4 associated the unstable bladder of childhood with "emotional imbalances affecting the child...," while Allen5 acknowledged that, in treating dysfunctional voiding, "parental understanding and support are essential for success, and when indicated, professional counseling for the family or child is sought." We explored the hypothesis that some young girls with unexplained urinary tract infections (UTIs) might benefit from brief psychotherapy.

Patients and Methods.—The 17 patients consisted of two groups of girls, ranging in age from 3.75 to 15 years. All girls had

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