Child UTI/Reflux/Double Ureter

[Rus__0]

  My questions concern my daughter born 8/94.  In June, 1998 she
  was diagnosed with her first UTI.  After 10 days on Bactrin, she
  had an ultrasound.  This showed a double ureter on her left
  kidney.  In late June she developed her second UTI and took
  Bactrin again for 10 days.  In July she had a voiding study
  done which showed reflux grade 2 on her right side.  She has
  continued to urinate frequently (every 20 to 30 minutes).  
  My questions are as follows:  1) Should she be put on a low dose
  maintenance antiobiotic?  2) We've been told that her level of
  reflux is "waited out" to see if improvement occurs.  However,
  with her abnormality on her left side is this still a good
  idea?  3) Should we be concerned about her continuing frequent
  urination?  She really hasn't been right since her first UTI
  in June, although she does not complain of pain or burning
  and has no fever.  
  Thanks for your help.
-------------------------------------------------------------------------------------------------------------
Dear Russ,
Urinary tract infections in children are a common problem. Bladder infections alone are not dangerous . However, reflux of urine into the kidney in combination with urinary tract infections can lead to kidney damage. Diagnosis of reflux in childhood must be made to prevent this damage. The evaluation of a child with recurrent UTI’s includes a renal ultrasound looking for dilation of the kidney and a VCUG to find reflux.
The VCUG ( Voiding CystoUrethroGram) is performed by placing a catheter in the bladder and instilling contrast material while X-rays are taken. This is a very safe test performed at most hospitals.Your daughter has undergone this exam and was found to have reflux.Reflux often resolves with time however it is imperative that she remain on antibiotics until that time. Otherwise, she will encore renal scarring and subsequent renal damage. Frequent urination can be a symptom of urinary tract infections therefore,her urine should be re-cultured to ensure it is free of infection. This information is provided for general medical education purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653 6568).
HFHS MD-KR
*keyword: pediatric UTI’s