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Urology (Expert Forum)
ped urology/UPOJ
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
ped urology/UPOJ
by mike__0__0, Jan 16, 1999 12:00AM
Our son was dx with hydronephrosis (mild) bilaterally inutero. At 2
months reflus test was neg. but renal lasix test showed bilateral
obstruction, right greater than left. 32% vs 68% respectively.
monitoring via renal lasix was recommended every 3 months with surgery
in the event of repeated infection or evidence of kidney damage.
I have heard that there is some controversy whether early intervention
is preferred vs. waiting.
Do you have an opinion? where can I get further info? how do you find
a urologist experienced with ped. pts?
thank you
months reflus test was neg. but renal lasix test showed bilateral
obstruction, right greater than left. 32% vs 68% respectively.
monitoring via renal lasix was recommended every 3 months with surgery
in the event of repeated infection or evidence of kidney damage.
I have heard that there is some controversy whether early intervention
is preferred vs. waiting.
Do you have an opinion? where can I get further info? how do you find
a urologist experienced with ped. pts?
thank you
Doctor's Answer
by hfhs M.D.-AK, Jan 16, 1999 12:00AM
Dear Mike,
I certainly think that you should see a pediatric Urologist in the near future, probably one of the main Hospital centers in the nearest large city would have one. A pediatric Urologist deals with these types of problems week-in and week-out Often they are affiliated with a pediatric hospital, one that performs ultrasounds, VCUG’s, and Lasix renal scans in children. These studies are more accurate because they are routine in these institutions. You could at least touch base with the Pediatric Urologist and follow with your local Urologist if necessary.
I don’t think this is an emergency if your child’s creatinine is stable, the state of hydronephrosis is stable, and your child’s is not having any infections. At minimum, following with every three month ultrasound and a second renal scan to detect interval change.
In terms of surgery, I don’t have the means to see your child’s films or labs. If there is any obstruction present, particularly on the lasix renal scan, I would think early intervention would be indicated rather than observation. If there is no obstruction, no reflux and no infection, I think an argument could be made to follow your child as already suggested by your physician.
There are several reasons that can explain the differential function results you gave me(32% vs 68%). Certainly both kidneys are functioning adequately that you would want to save them, even if surgery was the only way. These reasons include, obstruction, infection with scarring, or congenital anomaly.
Overall, I think a consultation with a pediatric Urologist would be in your best interest, even if a substantial distance was involved. Good Luck!
This information is provided for general medical educational 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).
Sincerely,
HFHS M.D.-AK
*keyword:Hydronephrosis
