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February 1990, Vol 144, No. 2 >
Article | February 1990

Urinary Tract Symptoms and Urinary Tract Infection Following Sexual Abuse FREE

Judy L. Klevan, MD; Allan R. De Jong, MD
[+] Author Affiliations

Accepted for publication September 25, 1989.

Read in part before the Third National Child Abuse Conference, Philadelphia, Pa, March 16, 1989.

Reprint requests to 111 S 11th St, Suite 8050 NH, Philadelphia, PA 19107 (Dr De Jong).


Am J Dis Child. 1990;144(2):242-244. doi:10.1001/archpedi.1990.02150260122044.
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References
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• During a routine follow-up visit, 428 victims of sexual abuse and their caretakers were asked about genitourinary complaints. Symptoms elicited included vaginal pain, increased urinary frequency, dysuria, and enuresis. A urinalysis was performed for all victims with symptoms, and those with positive or equivocal urinalysis results had a urine culture done. Urinalysis and urine culture were performed on a control group of 53 consecutive asymptomatic victims. Twenty percent (85/428) of the victims complained of one or more genitourinary symptoms. The most common symptom was vaginal pain (51%). Of the symptomatic victims, only 2 had a urinary tract infection. None of the 53 asymptomatic control victims had a urinary tract infection. There was no significant relationship between the presence of genitourinary symptoms and repetitive abuse, genital trauma, vaginal contact, or gender of the victim. However, patients younger than 6 years of age were more likely to have genitourinary symptoms than older patients. These findings indicate that urinary tract symptoms following sexual abuse are common but that urinary tract infection is quite uncommon. Our study does not support routine screening of children for urinary tract infection solely because they have been sexually abused.

(AJDC. 1990;144:242-244)

REFERENCES

1 +
Krugman S, Katz S, Gershon A, Wilfert C. Infectious Diseases of Children . St Louis, Mo: CV Mosby Co; 1985;:424-425.
2 +
Nicolle L, Harding GKM, Preiksaitis J, Ronald AR.  The association of urinary tract infection with sexual intercourse . J Infect Dis . 1982;;146:579-583.
3 +
Krugman RD.  Recognition of sexual abuse in children . Pediatr Rev . 1986;;8:25-30.
4 +
Goldenring JM.  Tracking down the cause of dysuria in adolescent girls . Contemp Pediatr . 1986;;3:50-68.
5 +
Reinhart MA.  Urinary tract infection in sexually abused children . Clin Pediatr . 1987;;26:470-472.
6 +
Lusk R, Waterman J.  Effect of sexual abuse on children . In: MacFarlane K, Waterman J, eds. Sexual Abuse of Young Children . New York, NY: Guilford Press; 1986;:101-105.
7 +
Adams-Tucker C.  Proximate effects of sexual abuse in childhood: a report on 28 children . Am J Psychiatry . 1982;;139:1252-1256.
8 +
Blumberg ML.  Depression in abused and neglected children . Am J Psychother . 1981;;35:342-355.
9 +
Rimza ME, Berg R, Locke C.  Sexual abuse: somatic and emotional reactions . Child Abuse Negl . 1988;;12:201-208.
10 +
Edelman CM.  Urinary tract infection and vesicoureteral reflux . Pediatr Ann 1988;;17:568-582.
11 +
Hammerschlag MR, Doraiswamy B, Alexander ER, Cox P, Price W, Gleyzer A.  Are rectogenital chlamydial infections a marker of sexual abuse in children? Pediatr Infect Dis . 1984;;3:100-104.
12 +
Ingram DL, Runyan DK, Collins AD, et al.  Vaginal Chlamydia trachomatis infection in children with sexual contact . Pediatr Infect Dis . 1984;;3:97-99.
13 +
Fuster CD, Neinstein LS.  Vaginal Chlamydia trachomatis prevalence in sexually abused prepubertal girls . Pediatrics . 1987;;79:235-238.
14 +
Hammerschlag MR.  Chlamydial infections . J Pediatr . 1989;;114:727-734.
15 +
Stamn WE.  Causes of acute urethral syndrome in women . N Engl J Med . 1981;;304:956-960.
16 +
Demetriou E, Emans SJ, Masland RP.  Dysuria in adolescent girls: urinary tract infection or vaginitis . Pediatrics . 1982;;70:299-304.
17 +
Chambers CV, Shafer M-A, Adger H, et al.  Microflora of the urethra in adolescent boys: relationships to sexual activity and nongonococcal urethritis . J Pediatr . 1987;;110:314-321.
18 +
Hovelius B, Mardh PA.  Staphylococcus saprophyticus as a common cause of urinary tract infections . Rev Infect Dis . 1984;;6:328-337.
19 +
Goldenring J, Fried D, Tames S.  Staphylococcus saprophyticus urinary tract infection in a sexually abused child . Pediatr Infect Dis . 1988;; 7:73-74.
20 +
Bailey RR.  Significance of coagulase-negative Staphylococcus in urine . J Infect Dis . 1973;;127:179-182.

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References

1 +
Krugman S, Katz S, Gershon A, Wilfert C. Infectious Diseases of Children . St Louis, Mo: CV Mosby Co; 1985;:424-425.
2 +
Nicolle L, Harding GKM, Preiksaitis J, Ronald AR.  The association of urinary tract infection with sexual intercourse . J Infect Dis . 1982;;146:579-583.
3 +
Krugman RD.  Recognition of sexual abuse in children . Pediatr Rev . 1986;;8:25-30.
4 +
Goldenring JM.  Tracking down the cause of dysuria in adolescent girls . Contemp Pediatr . 1986;;3:50-68.
5 +
Reinhart MA.  Urinary tract infection in sexually abused children . Clin Pediatr . 1987;;26:470-472.
6 +
Lusk R, Waterman J.  Effect of sexual abuse on children . In: MacFarlane K, Waterman J, eds. Sexual Abuse of Young Children . New York, NY: Guilford Press; 1986;:101-105.
7 +
Adams-Tucker C.  Proximate effects of sexual abuse in childhood: a report on 28 children . Am J Psychiatry . 1982;;139:1252-1256.
8 +
Blumberg ML.  Depression in abused and neglected children . Am J Psychother . 1981;;35:342-355.
9 +
Rimza ME, Berg R, Locke C.  Sexual abuse: somatic and emotional reactions . Child Abuse Negl . 1988;;12:201-208.
10 +
Edelman CM.  Urinary tract infection and vesicoureteral reflux . Pediatr Ann 1988;;17:568-582.
11 +
Hammerschlag MR, Doraiswamy B, Alexander ER, Cox P, Price W, Gleyzer A.  Are rectogenital chlamydial infections a marker of sexual abuse in children? Pediatr Infect Dis . 1984;;3:100-104.
12 +
Ingram DL, Runyan DK, Collins AD, et al.  Vaginal Chlamydia trachomatis infection in children with sexual contact . Pediatr Infect Dis . 1984;;3:97-99.
13 +
Fuster CD, Neinstein LS.  Vaginal Chlamydia trachomatis prevalence in sexually abused prepubertal girls . Pediatrics . 1987;;79:235-238.
14 +
Hammerschlag MR.  Chlamydial infections . J Pediatr . 1989;;114:727-734.
15 +
Stamn WE.  Causes of acute urethral syndrome in women . N Engl J Med . 1981;;304:956-960.
16 +
Demetriou E, Emans SJ, Masland RP.  Dysuria in adolescent girls: urinary tract infection or vaginitis . Pediatrics . 1982;;70:299-304.
17 +
Chambers CV, Shafer M-A, Adger H, et al.  Microflora of the urethra in adolescent boys: relationships to sexual activity and nongonococcal urethritis . J Pediatr . 1987;;110:314-321.
18 +
Hovelius B, Mardh PA.  Staphylococcus saprophyticus as a common cause of urinary tract infections . Rev Infect Dis . 1984;;6:328-337.
19 +
Goldenring J, Fried D, Tames S.  Staphylococcus saprophyticus urinary tract infection in a sexually abused child . Pediatr Infect Dis . 1988;; 7:73-74.
20 +
Bailey RR.  Significance of coagulase-negative Staphylococcus in urine . J Infect Dis . 1973;;127:179-182.

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