dd has an appt with the urologist

Around the time she turned 2, dd had a couple UTI's back to back. I was told after the last one "If she gets one more, she needs to see the specialist." Well, she was fine for awhile. Then last month, she ended up getting the swine flu & one of the things they did at the time was to test her urine; which showed white blood cells. They said could just be b/c she was sick, but to come back in a month & re test. She ended up being really sick after that (I think with mild pneumonia, but we never knew for sure) and every time they tested her urine, there was white blood cells; I can't remember if they said bacteria or not. Thinking she might have another UTI, the doctor prescribed antibiotics and in the meantime ordered a culture for the urine. We did the meds, but the culture came back neg for a UTI. Fast forward about 2 1/2 weeks & the poor kids is sick again with double ear infections. (she's had a really bad month!) Since it had been about a month from the first urine test & she'd already done 1 round of antibiotics, they did another urine test while we were there. They said it looked pretty much the same as the 1st one, and it was probably time to refer her to the urologist.

So, I just made her appt today......the dr is out of town for a few weeks, so they can't get her in til Dec 2. I think they said it would be more like a consultation the 1st visit, but has anyone been down this road & could maybe tell me what to expect?

 

:hug: I have no advice but wanted to let you know that both of mine have had UTI's. Mattie has had 3 and Lauren 1. Lauren is scheduled for a follow-up on November 23 and he is going to talk with us about having a kidney scan for both of them then.

I wish I had something to tell you. I am worried, but not letting on too much about it. From what the doc said initially they tend to grow out of these things.

 

I haven't been down this road as a mom but, as a former urology nurse I can tell you what to expect at the visit.

First of all they will do another urinalysis. Usually (at least in the office I worked in) we would run a urinalysis dip stick. A machine actually gives you a print out of the urinalysis results...BUT the doctor will also look at the urine under a microscope. The doctor usually goes with what he sees vs. what the strip reads. You can sometimes have a false positive with UA's. Sometimes normal skin cells can cause a false positive (not getting a midstream sample or peeing down your leg). If it does come back with white cells, they will either send it for a culture or they will want to obtain a sterile catheter sample (where they insert a small tube into the bladder and obtain urine). In our office, especially with kids, we would go the least invasive route first.

The urologist should be able to tell when he looks at the urine under the microscope if it is a false positive. Even though the urine strip cannot differentiate between blood cells and skin cells, the doctors eye should be able too. Unfortunately, most primary docs just do the dip stick without looking at it themselves too.

If is is not a false positive, they will probably just treat the uti and bring her back for a repeat urinalysis. If the culture is negative, they may want to do some xrays or they might even (I emphasize might)want to do a cytoscopy. Where they take a small camera and look inside the bladder. Usually, though, most kiddos just had recurring uti's and would be treated with prophylactic antibiotics (taking a low dose antibiotic every day for months). We would just bring them in periodically and check the urine to make sure it was staying clear. The good thing is that most kiddos usually grow out of it.

Good Luck! It is better to get things checked out to be on the safe side!!

 

Laura,

Not to hijack, but pedi mentioned something about the "flap" at the bottom of the tubes and the top of the bladder not closing fully which causes urine to back up. I think he mentioned the prolonged antibiotics and after age 5 there was a procedure that could be done if necessary. Again, it was hard to understand everything he was saying with both girls destroying the exam room in the process.

Can we declare you the official consultant to matters such as this?

 

:laughing: Hahaha...I don't know about "official" consultant, but I will be happy to answer questions as best I can.

Your ped. is probably referring to reflux. Vesicoureteral Reflux(VUR) to be exact. Usually they do a VCUG (an xray they take while voiding). Treatment depends on how bad the reflux is...Grade 1-5. Yes and there is a procedure that can correct it. The lower the grade the more likely the child will grow out of it and usually will just use prophylactic antibiotics.

 

Laura - thanks, that actually makes me feel a lot better. I'm trying to remember, but I think the uti's she had when she was 2 they told me they were very mild & even then the doctors seemed confused by the results.

 

PS - I think they were confused b/c her urine didn't show raging infections, but she was obviously very sick (temps running around 105)