VCUG for one year old son

[rajps]

My son is one year old and he had a UTI a month ago, he was treated with antibiotic called Bactrim and after his course of 10 days ,the urine analysis was done again, and the bacteria was cleared up and completely cured. the pediatric suggested ultrasound and VCUG. the ultrasound was perfectly normal and no abnormalities were discovered too on kidneys, this was my son's first UTI. my question is ,,do we do the VCUG test or can we wait to see if he gets second round of UTI.

Below are my questions or my ideas if anyone can share too theirs.

1. What are the risk to wait and see if he gets second uti and get VCUG done then?
2. If we dont go for VCUG and if he gets fever again of any sort, I would still go for urine analyis since UTI was once reported. this would give us some lead time to work on UTI if discovered soon rather than wait 2 days before getting urine analysis done. Also I am planning to go for urine analysis at least once a month to see if everything is normal if we opt out of VCUG
3. The urologist has recommended sedation. is it ok to sedate our one year old, I have this basic question though is VCUG necessary since that would require sedation .
4. One of the test in VCUG is the patient urinates after the VCUG test and then a xray is taken, in case of sedated patient how does it work? what options do doctors use to complete the VCUG Test.

[Rowena Santos, MD]

How are you? How is your son? Urinary tract infection (UTI) is a common problem in children, which occurs in up to 5% of girls and 1% to 2% of boys. The combination of Vesicoureteral reflux and UTI may predispose children to pyelonephritis, renal scarring, hypertension, and chronic renal disease. To evaluate for reflux most authorities recommend a voiding cystourethrogram (VCUG) on all males and younger females 3 to 6 weeks after the first UTI.

To read more on VCUG procedure and what to expect, this link may be of help: http://www.radiologyinfo.org/en/info.cfm?pg=voidcysto

It is good that his kidneys are normal in the ultrasound. The prevalence of VUR in children with UTI decreases with age. Reflux is more common with infants less than 1 year old. If you are not comfortable with the idea of VCUG, you discuss other options with your doctor.  

I hope this helps. Take care and keep us posted.

[runt1275]

As the mother of a son that was born with PUVS (posterior urethral Valve Syndrome) which is a big medical term for a blocked bladder He has had several VCUG's. The bladder blockage caused Hydronephrosis or reflux into his kidney which in turn damaged his kidney.After he was born they did a surgery at about 5 months and trimmed his valves between his bladder and his urethra which caused the  blockage.  they did a VCUG on him to see if he still had reflux to his kidney.  Your ureters (connect kidneys to bladder) are supposed to be one way his were two ways allowing urine to back up and damage his kidneys. I have never heard of doing a VCUG for a UTI.  My son also had one with sedation at about a year old, the sedation is just to keep them calm.  With a VCUG the will strap him to a backboard at his knees and his chest. then they strap his arms up over his head and strap his head down. then they will insert a small catheter into his penis into his bladder. they then will insert contrast (dye) into his bladder to see if it is refluxing into his kidneys by taking xrays at the same time. I know this sounds overwhelming and traumatic but it hasn't effect my son at all. But I am like you with a UTI I don't see why they would want to do a VCUG unless he has been diagnosed with reflux. my son is prone to UTI's because of his disorder (thank goodness he has only had one) But with that one they just did a urinalysis and put him on Bactrim. I wish you the best. I suggest if you do the VCUG that you go and not your husband(if you are married) it can be a little squemish for the men.

[traciev]

Hi. I'm a mom of a 5 year old with PUV's. They caused fetal hydrops, premature birth, kidney damage and now his bladder does not work like it should. We have had his valves done twice, but there is still reflux.  I am wondering if you or anyone else has had trouble like that?  They are now talking major surgeries, scares me to death.

[runt1275]

Hi - My son was born with PUVS like you can see in the post.  I guess his may not have been as severe as your child. But he had his left kidney removed because the reflux had done so much damage. His right one is fine no Reflux. He has a Vesticostomy right now while his bladder is developing his urethra is clear but he also urinates out of the Vesticostomy if his bladder gets to low pressure. My son has had 4 surgeries and he is only 2. First one was at 24 hours old they created a vesticostomy (hole in his tummy that leads to his bladder) he used that to urinate for the first 5 months until he was bigger to be able to trim the valves. At 5 mos they trimmed the valves and reversed the vesticostomy, at 1 year they trimmed the valves again and then at 1 yr. 6 mos he had his kidney removed and created another vesticostomy with the ureter until he is potty trained. when he was born his creatinine level was 5.4 now after all that it has stabilized at .4 to .5 with diet. I trust my Urologist and Nephrologist completely.  I know it is hard.  I send out prayers to you. My son is my first child but I knew he was going to be born this way I found out when I was 30 weeks pregnant. My son has surpassed what the Dr.s originally told me when he was born.  They were talking Transplant by age 4 and dialysis but with good dr's and a lot of prayer and dedication to make him better he is doing well.

[tracier]

My thougths and prayers are with you and your son. As a mother I know how scary having something wrong with your baby can be. Stay strong!!