Pediatric Urology

[hayati]

My son was hospitalized at 14 months for suspected UTI/ pyelonephritis. It was his 1st UTI - the only symptom he had was fevers & a runny nose - we thought it was upper respiratory & was very surprised that it was a UTI After he was discharged from the hospital, the doctor told us to get a VCUG done & that showed that he had Grade 3 reflux in his right kidney. The doctor told us to see a nephrologist. I asked if we should see a urologist instead but she was pretty sure & adamant that we needed to see a pediatric nephrologist. So that's what we did. He was on abx prophylactically for a while until he developed a rash on Bactrim, could not tolerate Furadantin (gave him the runs really badly) & was still getting UTIs. We stopped the antibiotics. He was fine for about 6 months until last month he got fevers again & we assumed it was another UTI He is now 2years 3 months. We did a bag specimen but by the time we got the culture results, he was himself again. The doctor told use to treat anyway because the specimen grew some bacteria. Half way into the treatment, my son began acting out of the ordinary again with fevers. We did another bag culture & this time it grew Pseudomonas. That's when we went back to the nephrologist. She says that bag specimens are not accurate & she says we should have been collecting catheterized specimens all along when he gets sick. Is that true? Anyway, the nurses at the pediatricians's office could not get a cath specimen (when he was in the hospital, the nurses had the same problem). So we made an appointment at the nephrologists office to have it done today. They finally got it but my son wasn't a happy camper. For at least 6 hours, my son didn't pee - his diaper was totally dry. He was clutching his crotch sometimes & saying owwie or pee pee. But after a few moments he'd be fine again & playing & laughing. Finally before bedtime, I sat him on the potty & I think the urge got too great that he just let it out but he was crying. There seemed to be a lot of urine - a lot of it got on the floor as he squirmed & tried to get up a few times because of the pain. But then again, a few minutes later he was off running & playing. I don't know if this is a problem. He's asleep now & seems okay. But I'm worried that in catheterizing him, the nurse might have caused some damage? Or is it just a bruise & it will heal itself? Anyway, I just found this forum & now I'm wondering if we've been given bad advice all along. Should we go see an urologist? What should we do next? The nephrologist has us taking him in for a nuclear cystogram next week.

[MyKidsRock]

Just saw your post. Wondering how the nuclear scan went. My daughter has grade V reflux on both sides. We have seen a urologist and nephrologist, but most of our visits are with the urologist. You should be fine with either doctor, but if your uncomfortable with the nephrologist I would ask for a referral.

As for the catheter, our doctor insists on a cath when testing for UTI because it is less likely to be contaminated. Unfortunately it's also uncomfortable. I hope your little one recovered quickly!