"pimples" in the bladder

Posted by Robin on July 12, 1999 at 12:26:40
Hi, my 5yr old daughter is being worked up for frequent UTI's.  She's had an ultrasound, VCUG, IVP, another VCUG-like test with a "neuclear something" to it.  Nothing is showing.  With her UTI's she's had 2 kidney infections associated as well.
Her pediatric urologist wants to do a cystoscopy looking for "pimples" in the bladder.
If those are there he says he'll treat her with stronger medicines.  I'm just not sure why not treat her with "stronger" medicines anyway and avoid the risks of putting her to sleep for the test.
I looked through the board here and didn't see discussion of this, but maybe I'm not aware of the proper term for it.
I would appreciate any information you can share on this 'cause I'm stumped.
Thank you, Robin
PS I did read with interest your comment to one mom about the constipation factor which is an issue with my daughter.  I'll work on that "end" of the problem too.

Posted by HFHS M.D.-JS on July 16, 1999 at 13:47:59
Dear Robin,
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Thank you for your inquiry.  Children who develop urinary tract infections often have an underlying anatomical abnormality in the urinary tract.  Thus, the Ultrasound and VGUG are ways to diagnose these abnormalities, and to identify if there is vesicoureteral reflux , which can  predisose children with lower urinary tract infections(cystitis) to upper urinary tract(pyelonephritis)  infections which can have long term harmful effects.  If a child is suspected or documented to have reflux, then he/she is placed on prophylactic antibiotics.  The tests do not always diagnose a  cause for the infections and further more specific tests are recommended, i.e. cystoscopy, renal nuclear scan.
Since you are seeing a pediatric urologist they are experts in this field.  The