Test for Immature Urethra??

H.,
My youngest daughter had the test done about 6 years ago at Self Regional Hospital. The nurses and dr.s were so nice to her and gave her a teddy bear to hold (& take home with her afterwards) while she was having the procedure done. There were some tense moments for both us, but we knew it had to be done to get to the bottom of her problem. The hardest part was getting her to hold the fluid in until they were able to get all the x-rays taken. I was able to stay in the room with her and hold her hand the entire time.
The results showed that she did have a problem where urine was back flowing into the ureters when her bladder got too full. Besides taking several rounds of antibiotics, we, along with her teachers, had to make sure that she took frequent "bathroom breaks" to help prevent her from having recurring infections. Our Ped. and the Nurse Pract. told us to not let her take baths, especially bubble baths until she gets to be around 12 or 14, when they figure her urethra will be smaller (mature).
We followed their instuctions, she's been taking showers ever since and has only had two mild "Flare-ups" in the last 6 & 1/2 years. I attribute those "Flare-ups" to two teachers that failed to understand the importance of following my instructions on letting her go to the bathroom when she needs, not when they schedule everyone to go. They caused my daughter to suffer not just the pain, but also embarrassment for having an "accident" during class.
Talk to your Ped. about dietary, as well as personal hygiene issues that can also have an effect on UTI, every little thing that can help your daughter stay UTI-free.
I wish you luck and I hope that our experience can help your daughter.
Milly S.

I understand your concern. My little one had to go through something called a barium enema in trying to diagnose something she had going on at about three. Man, it's tough. My best advice is to stay positive with your little girl. Tell her you're very proud of her and that she's doing a great job. NEVER let her see that you're upset by the whole thing. Your job is to make her feel like the adults are in control and safe. Even though she doesn't like it, "Mommy's here so I'm okay."

Good luck!!!

My son had a sergury when he was 6 to enlarge his urethra and I saw no change at all.

I may sound like a simpleton, but making sure a child ( or adult) stays well hydrated with good, clean, water can reduce or prevent infections. The bladder filters impurities and when water is coming to the aid of the bladder to dilute these impurities, it is easier on the kidneys and bladder. The bad stuff, has less contact time with the bladder and is passed in a dilute which flushes the urethra. Withhold carbonated drinks and sugary drinks and give your child half his body weight in ounces of water a day for a month or two and see how that works. Water ( good filtered water, not chlorinated tap water) promotes better health, better energy, better weight control, better clarity of mind and reduces urinary problems naturally. God designed our bodies so that every cell of the body depends on water for optimal performance.

Has she only had one infection? My daughter had a UTI on her 4th birthday. Between the ER doctor and her doctor they said that as long as it's not a recurrent problem it's not a big deal and that sometimes the infection get started if they are not wiping right after they have a bowel movement. If it has only happened once I would research if the procedure is really necessary or not. It's been 8 months since my daughter had hers and has not had any problems again.

Hi H.,
My daughter was 3, almost 4 when she had a severe UTI. Her pediatrician suggested she have this test if she continued to get UTI's. Luckily, she only suffered one more after that. We figured out it was from her sitting in the tub after I would wash her hair; the shampoo was irritating her. I started showering her instead of bathing and things improved. If this is your daughter's first infection I would ask her pedi. if you could hold off before you have the test done to see if she continues to get them. I was told the test can be painful, I couldn't see putting my little girl through that unless it was necessary. Potty training could be an issue too. The pedi. we used told us to make sure we go with her to potty. Hope this helps. If the problem had continued with my daughter, I would've had the test performed.
Good Luck! If you have to have the test performed, I hope everything goes well.

Honestly, I wouldn't do it. It's a horrible test. My daughter had a UTI when she was 3, and the ped suggested the tests. We did the ultrasound, but I refused the VCUG. Coincidentally my son was seeing a urologist for an unrelated condition and I asked him what he thought. He said, "I see no reason to put a small child through that test on the basis of one UTI. If she gets another, consider it, and a third would make it necessary. If it were my own child, I'd say no." I figured peds will be conservative automatically, but the urologist is a specialist and was the expert. My daughter is now 5 and has not had another UTI, so I'm glad we didn't do it.

My son had to have this when he was about 6 months old or so. It is not nearly as bad as it sounds and we had it done at Children's Health Care of Atlanta (or Scottish Rite??? I cannot remember which one) and the people were extremely nice. It is more uncommon for a boy to have a UTI but we did the VCU just to rule out anything else. Everyone at the hospital said the children cry more b/c they are nervous with all the people around and not b/c anything that is done really hurts them. Good luck. She will do fine.

My son had to have this test done on him when he was a little over a year old. It's a VCUG test. I was also concerned, but the thing that upset him the most was being restrained. Maybe by her being 3 you can explain to her that they will hold her arms and legs so she doesn't squirm while they are putting in the cathader. It didn't seem to be painful to him, and it was explained to me that he would only feel pressure. After the test we took him to get some ice cream, that made everything better!! I think the best thing you could do for a 3 y.o. is explain to her what is going to happen and what pressure feels like. Good luck!!

Has she had the ultrasound yet? My daughter had a UTI and the ultrasound showed she was ok. You may want to get the ultrasound done and read by a radiologist before you do the other test. We opted not to do the other test because of the amount of radiation involved. I work in radiology so I have some experience with this. It is not good unless absolutely necessary to expose your child to so much radiation. Granted if the test is a medical necessity by all means do it. I would just get a second opinion. Good luck!

Unfortunately I have a lot of experience with this! My 2nd boy born last October has bladder reflux. Normally it ends before birth, but his didn't and he had to have this test you describe at 1 month! He's been on antibiotics since and will continue until 18 months. In our family it's hereditary. I had terrible problems with this when I was a girl and had to have bladder/urethra surgery at age 9. They've come a long way with treatment now! The worst is some discomfort and pain -although catheters are not as painful as one might think (especially if you absolutely cannot pee -then they're a relief!) -but it is uncomfortable. She'll definitely deserve some treats afterward! They'll have to do the test on my son again at 18 months, and probably afterward to make sure he's progressing ok. At least this test will give them the info they need to treat her problem so she won't have tons of UTIs, emergency catheters, and possible kidney damage.

H.,
Usually when someone has repeated infections, it's because their body is not absorbing some nutrient it needs or there is something in their environment that they are reacting to. You only mentioned one infection and that has me concerned. Have there been other serious problems since she was born? For your daughter, it can be as simple, and strange, as the need to change laundry detergents. It could be a lack of a vitamin or mineral or a reaction to some food she’s eating. In my opinion, some doctors are way too quick to put us and our children through painful and unnecessary tests because they have no idea that the body can heal itself if we give it the right tools. Medical school has drummed that out of most of them and pharmaceutical salesmen are training them in treatment. Listen to M.D. Gena that responded here because she seems to have more sense.

The second thing I would be concerned about is having her on long-term antibiotics. You do realize that it will suppress her immune system so that she will be susceptible to every disease out there and there is nothing you can do to build her immunity at that point, don’t you? Did the doctor tell you that? How much better to cure and prevent further problems with a strong immune system? I personally would want to try several things less invasive on a 3 year old.

I teach wellness seminars for adults and children and have a Masters degree in Education, not Medicine, but I’ve been trained by some of the best natural healers – nutritionists, cancer specialists, chiropractors and homeopathically trained doctors. I consult for free and would be glad to interview you to look at possible causes for her condition. I can’t promise anything except it won’t be painful or dictated by insurance and we might come up with a simple solution. I can recommend some absorbable vitamins that will build her immune system that are not expensive and look at lots of other options.

My daughter went through that at an earlier age--around 12-18 months, I think???? Anyway, it's very quick. You can indeed see the reflux happening on the Xray screen WHILE it's happening. It was just comforting to know what the problem was and how to treat it. She was on antibiotics for over a year, which was a pain, but she got used to it and didn't fight it. She eventually grew out of it. The immature urethra runs in the family, so you might be checking your other daughter at some point... Good luck. Get it over with and have an answer.

Hi H.,

Is this your daughters first UTI? Or have there been multiple infections in the past? If this is the first one there really isn't a major indication for her to undergo this procedure just yet. Let her take the full course of antibiotics and let her heal. Then you can keep a close eye on her to see if she develops another one in the future (which would warrent an investigation). But if your daughter has repeat cases of UTI without identifiable causes (like wipping in the wrong directions and infecting her urethra with stool) would require further work up. Including an ultrasound and voiding cystourethrogram (VCU). Go to this website to read more about it... http://www.radiologyinfo.org/en/info.cfm?pg=voidcysto. But also please be aware that even if this VUR (vesiculo-urethra reflux) is found the treatment remains the same as if their was no diagnosis with the above procedure. Meaning, whether you find out for sure or not if she has VUR the treatment won't change. She will still be placed on antibiotics every UTI she has, until she finally grows out of it. You must weigh the risk and stress of the procedure with the benefit of the procedure. The only thing the procedure will give you is a name and a certain diagnosis. It doesn't change anything else. And your little one will have to endure the stress and discomfort of the procedure. Please look at what's before you and make an INFORMED DECISION! That is the job of every patient/patient's gaurdian.
Lastly be aware that if she does in fact have VUR, a minor UTI can turn into a nasty kidney infection called pyelonephritis. This is very dangerous and can cause widespread kidney damage that may not be repairable. So whether you get a certain diagnosis or not, your job as her parent is to be vigilant and keep an eye out for signs of a UTI and get it treated immediately. Something as simple as a fever needs to be addressed quickly. Please also inform yourself of ALL UTI symptoms so you can be on the look out.

I hope this information helps you. From one parent to another.

God Bless
G. Mastrogianakis M.D.

My daughter had similar test while 3-4 years old and was traumatized for a while and didn't want anyone near her panty area.

I had cystiscopics as a 5&6 year old and was never sedated. I was told at 18 years old by an adult urologist that he had never did a cystiscopic on a child less than 18 years of age without putting them to sleep. He put me in the hospital and sedated me at 18 for the test for my comfort.

I have been having recurring UTI's and am fixing to have to go through this again, my nephrologist (kidney doctor) recommended this process for trying to find out why I am having the recurring UTI's, he has ruled out kidney problems. He told me I might as well not go to the urologist if I was not willing to have the cysto. At almost 45 I still have problems with fear of this procedure. My doctor has assured me that things have improved over the last 20+ years where I should have very little discomfort? I'm still nervous!

My daughter was having to go to the restroom constantly, and the test did not reveal a problem. The kidney doctor says she has a curve in her uretha tube and it may or may not cause problems.

We both have blood traces in our urine and that is why we have had to be rountinely checked and outrule any other complications. No other side affects, just routine - other than now the UTI's.

As my doctor said, if we want to get to a possible diagnosis we have to suffer the tests??? I'n not looking forward to mine, and I know you are nervous about your daughter's tests. In the long run, these aren't comfortable for adults but we do what we have to do I guess - Good Luck!

By the way, I found out three years after my daughter had these test that revealed nothing that she is ADHD and this contributed to her brain thinking she had to go more often, not proven, but made sense to me. When she had to go, she HAD to go, and she did every time!

Good luck with your situation. But, hopefully it will give you a peace of mind to know the outcome. Make sure they let you stay in the room with her.. they almost made me leave the room, but my daughter pitched a screaming fit and would have been worse if I had left the room.

M.

I have never had the test, but am a nurse who has performed it MANY times. You are right that your daughter will be upset, but know that you are doing what is best. Some facilities do limited sedation with children. Unfortunately you will need her to be aware enough to pee while on the table, so she can't be put to sleep for it. Most children don't like being in a strange environment, don't like being exposed from the waist down, don't like being held still, and obviously don't like being touched in a private area. Unless you are pregnant, you or father should be able to stay with her, but she will still fight. I never fuss at children who cry, kick or fight. I just reassure them that it will be over soon....and most importantly, or at least to me as a mother, make sure I tell them that no one should ever touch them in that area unless mom is there and says it is OK (meaning doctors). As soon as the bladder is filled the catheter is removed (this does not hurt). Usually the children are happy, laughing and forget quickly once the test is complete. Another important point....when you get home, make sure she takes a bath (I know they say baths can cause UTI's, but need this one). I say bath and not shower because the betadine used to cleanse the bottom gets everywhere (all cracks and crevices), and will itch really bad as the day progresses. I hope this was of some value, and I will keep you in my prayers! I agree that if this is the FIRST UTI, then maybe you should treat, do ultrasound, and wait on the VCUG. Of course if she has another, or the MD can give you a concrete reason why it is imperative to do it now, then I'd do it.

I haven't read the others responses yet, but we went through this last year at MUSC. (I just went back and the best, common advice I saw was that if this is only her first one, don't have the test done. I completely agree - if it's number two or three, then I would proceed).

My daughter has a condition called VUR which affects the Ureter attachment in the bladder. Although her diagnosis is different from what your daughter potentially has, the procedure is the same.

1) The staff at MUSC is awesome. They were so gentle with her (she was 5 months old at the time). You get immediate results. Our results changed for the better when we met w/ the urologist the following week (Dr. Aronson).

2) Radiology shares the same floor with pediatric cancer treatment, so waiting in the waiting room is sad, but makes you thankful that you have to deal with a bladder issue.

3) It is intimidating when they start the procedure. 4-5 people are involved (partly because there are a few med students observing). They wear radiographic gowns, etc. So it's a lot.

4) This test was "easy" on a 5 month old, but I can't imagine on an older child. It is going to be scary, I won't lie. It won't hurt her, it will just be uncomfortable and nerve wracking. We have to have it every year until her situation clears, so my daughter will repeat it in September. The good news is that it's pretty fast. Prepare her the best you can so there is no surprises. I found with my older son (3 years old) that if we role play before hand it makes the procedures go easier.

5) We take a daily antibiotic (Septra). We have had no side affects, except we are more susceptible to yeast infections. I keep topical Nystatin on hand!

And that's about it - the good, the bad and the ugly. Hopefully her tests will be clear and she will be just fine! If not,

Are there other symptoms besides an infection to prompt such a barbaric test? It sounds fungal and inflamed to me, with bacteria being a secondary problem. I would try threelac, or another acidophilus. You can also try a little oreganol oil or juniper or soverign silver. Is her tongue coated white? Try to find an alternative practitioner. That guy sounds like Joseph Mengela..

okay - we have had two VCUG's. one when my daughter was 2 and one at 3. she has kidney reflux and has been on the antibiotic now for almost two years.

i wish i could sit here and say it was okay, but it was NOT. at least for us. now, we do have a friend whose little girl did just fine. so every child is different. but my daughter happens to be melodramatic in nearly every situation, so an unpleasant one is only exacerbated by her tendency for the dramatic.

your daughter will lay down on what is essentially an x-ray table. they'll put a little numbing agent on all her little "parts" and then catheterize her with a small, tiny, teeny catheter. they'll pump dye into her bladder and fill it to capacity, leaving your daughter with the urge to urinate. the idea then is for her to release her bladder while lying on the table, so that the x-ray can see if the dye is being expelled from the body, or traveling backward up the urinary tract toward the kidney.

my daughter has refused, amid screams from her and pleads from mommy, daddy, doctor, nurse, to urinate on the table. so both times we have ended up with daddy picking her up, running to the adjacent potty, letting her "go", and then RUNNING back to the table (just two or three daddy-steps away) to lay her down and get an image of where the dye crept.

my friend whose daughter did this successfully had her child lay down on the kitchen table on a towel and practice urinating while laying on a table. it eased her anxiety and served as a practice run - so if your daughter would respond well to that, go for it. mine would have freaked out even more, so it was not a good plan for us.

my best advice after doing it twice is to go to the store with your daughter, buy a toy she has been wanting, don't open it, but take it to the appointment. use it as incentive to get through the procedure, and obviously give it to her whether she does "well" or not.

i'll say a prayer for you! it's not pleasant, but it's quick.

I had this test done when i was around 6. I don't remember any pain, but I do remember crying a bunch because I had to go to the bathroom so badly, but between having something shoved up your urethra and being trained to only go on a potty it was so difficult to relax my muscles enough to go. But at 3, your daughter shouldn't have that problem. :-)

My daughter had the same test when she was 6 weeks old and again every year until she was 4. She did have kidney reflux, which is 100% hereditery. She was on antibiotics everyday until the age of four. The test is worse on the mom than the child. My daughter is a fighter so she fought each test where they would have to bring in extra people to hold her down! I do know someone that has a daughter who had the same test that never fought it & it was no problem for them! My advice: Pray for calmness for yourself & daughter; make sure that the test is done at a children's hosiptal (bad experience with tech's that are not trained to work with kids); talk about the test with your daughter, try to explain that some hosiptal workers will have to hold her down to make sure that the test turns out alright. It can be a scary test if your not prepared! Inform your daughter & yourself as much as possible. It will be alright. I'll say a prayer for you & your daughter. I hope everything works out alright.
A.