Introduction. This review is dedicated to analyzing the relationship between urinary tract infections (UTIs) and vulvovaginitis (VV) in prepubertal girls – a frequent and clinically significant comorbid pathology.
Objective: to systematize modern data on the etiopathogenesis, clinical features, and principles of differential diagnosis of combined urogenital pathology – UTIs and VV – in prepubertal girls, with an emphasis on assessing the cause-and-effect relationships between these conditions.
Material and Methods. An analytical review of Russian and foreign scientific literature was conducted, including publications in peer-reviewed medical journals, clinical guidelines, and epidemiological research data. The analysis included studies focusing on the anatomical and physiological features of the urogenital tract in girls, microbiological, immunological, and clinical aspects of UTIs and VV, as well as issues of diagnosis and treatment. The methodology is based on the comparative analysis and synthesis of data from selected sources to identify patterns and construct pathogenetic and diagnostic models.
Results. Analysis of the literature established a close relationship between UTIs and VV in girls. This connection is due to common anatomical and physiological prerequisites (proximity of structures, hypoestrogenism, immune system immaturity) and a shared spectrum of pathogens, primarily intestinal microflora, especially Escherichia coli. The predominant pathogenetic scenario is the development of a UTI as a complication of primary VV, though a reverse link is also possible. A key clinical and diagnostic problem is the similarity of symptoms (dysuria, leukocyturia), leading to frequent errors such as overdiagnosis of UTIs. The crucial diagnostic element identified is the mandatory examination of the external genitalia, upon which a stepwise diagnostic algorithm is proposed.
Conclusion. The relationship between UTIs and vulvitis in girls is a natural phenomenon that forms a vicious cycle of mutual infection and chronicity. To break this cycle, clear differential diagnosis is necessary, based on the mandatory examination of the genitalia and the application of a comprehensive laboratory and instrumental approach. Effective management of patients with combined urogenital pathology requires interdisciplinary collaboration between a pediatrician, a pediatric gynecologist, and a nephrologist/urologist.