Kidney reflux test?

Desarae - posted on 02/27/2012 ( 2 moms have responded )




My daughter is three years old never had problems with urinating but this past month she had a uti (her first ever). We put her on the medications and no problems since, we even got an ultrasound. The ultrasound showed both kidneys to be of normal size but one had slight swelling so now the Dr wants us to have the dye test done. I've heard this can be very traumatic and we have recently had to seek therapy for recent trauma and I am VERY reluctant to put her through any more for one UTI...thoughts? I explained to the Dr I would like a second opinion of a Urologist and discuss the option of monitoring with urine tests and ultrasounds vs something that could traumatize her for the rest of her life.


Sarah - posted on 02/27/2012




Get the opinion from the urologist (get a pediatric urologist if you can). Having said that, the test is called at VCUG. They put a catheter in, inject the dye and xray as they urinate to see if it is refluxing. I'm VERY familiar with this because my daughter did have VUR (Vesicoureteral Reflux). Essentially the danger IF she does have it is that it can cause permanent kidney damage. The Reflux in itself is not dangerous, but it puts the child more at risk for infection, and if that infection gets into the kidneys, it can damage them. There are different grades of reflux, from 1 through 5 (5 being the most severe). It can be on one side or on both.

If she does have reflux, depending on the grade/severity it's usually treated with daily low-dose antibiotics to prevent infection and protect the kidneys. Usually you also have frequent monitoring (yearly or more VCUGs, kidney ultrasound, monthly urinalysis). This is pretty standard care for it (and I did a TON of research because my physician couldn't tell me a lot about it).

You have options though! Personally, I would have the VCUG because IF she does have it, it can be something that could potentially affect her long term health and life. But, they may be able to offer her a light sedative such as chloral hydrate or conscious sedation. As unfortunate as it is to have to undergo the test for a toddler, and yes, it would be traumatic, usually where I live young kids are sedated for it, it could potentially change how you would treat it.

If she does have it, if you don't want to do the frequent monitoring, there is also surgical options to repair it. There is open surgery where they make tiny incisions and detach the ureters from the bladder wall and reattach it elsewhere along the bladder wall. This has an extremely high success rate (98%). Is usually around a 3-4 hour surgery. Or there is Deflux. This is about a 15-30minute operation. They put a uroscope through the urethra into the bladder and inject a sugar solution at the junction where the ureters meet the bladder. It has about a 82% success rate. If it doesn't work, it can be redone, and then success rates are the same as open surgery. If it still doesn't work, it doesn't preclude them from doing the open surgery later.

We opted for the Deflux procedure with our daughter because she had bilateral (both sides) grade 3 reflux which means she only had about a 50% chance of it resolving in 6 years, we didn't want to make her whole early childhood about medications and invasive procedures, and she had 3 allergic reactions to antibiotics. 7 months post-op and she's had no infections. Our surgeon has not done a repeat VCUG because he didn't want to traumatize her, and said that if she makes it 6 months post op without she'd be considered repaired.

I know this is a lot of information. I hope it helps you to make a decision. I also truly hope that your daughter doesn't have this. If she does though, please know you have options. Good luck!


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Katherine - posted on 02/27/2012




Definitely get the second opinion before you go through with this.

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