Recurrent urinary tract infection in girls: do urodynamic, behavioral and functional abnormalities play a role?

Background: To determine urodynamic, behavioral and functional abnormalities predisposing to recurrent urinary tract infection in 5- to 17-year-old girls. Methods: A prospective case-control study was carried out. A total of 148 girls met inclusion criteria. They received a careful evaluation including complete history, voiding-drinking diary, bowel questionnaire, physical investigation, sonography, voiding cystourethrogram and urodynamic investigation. Results: In a multivariate model, independent risk factors for recurrent urinary tract infection included age <= 6.5 years at first urinary tract infection (odds ratio [OR] =0.9; 95% confidence interval [95% CI], 0.85-0.98), abnormal voiding frequency (OR=5.3; 95% CI, 1.1-26.2), voiding postponement (OR=3.8; 95% CI, 1.4-10.1), poor fluid intake (OR=9.2; 95% CI, 2.5-33.6) and residual urine volume of > 20 mL (OR=1.1; 95% CI, 1.0-1.1). Conclusions: Independent risk factors for recurrent urinary tract infection were age <= 6.5 years at first urinary tract infection, abnormal voiding frequency, voiding postponement, poor fluid intake and residual urine. Our results indicate that none of the urodynamic factors was significantly associated with recurrence of urinary tact infection in girls.