April 25, 2010,
D.L. asks from San Jose, CA on January 29, 2008
VCUG (Vesicoureterogram)/ Catheter for 2 Year Old?
My 2 year old was found to have slightly large kidneys (grade 1 and grade 2), and the doctor's recommendation is to do this procedure called the VCUG, which includes a catheter and inserting dye to see if everything is operating properly. If it comes out normal, we just do ultrasound in the future to monitor the kidneys. If not, it could be a serious problem.
I respect my pediatrician very much, but as a mom I just don't want to put my child through any searing physical pain that isn't ABSOLUTELY necessary. My one experience with a catheter (right after giving birth without epidural) was more painful than childbirth, so this is obviously coloring my reluctance. I wonder if it would be okay to wait a bit, do an ultrasound to see how the kidneys are sized, and only go through the procedure if there continues to be a problem. Not that it's going to get any easier on him when he turns 3...
Does anyone have any experience with this? I would appreciate any feedback from moms who have gone through the same thing, particularly with a catheter, if not a VCUG.
So What Happened?™
Thank you everyone, for sharing your stories and all your encouragements. We finally decided to go ahead with the VCUG, and it went MUCH more smoothly than we expected. The catheter was uncomfortable, but not painful, thank God. They used a numbing agent, which helped a lot, and gave him a lollipop to suck on, which also helped. We didn't know this, so we brought along lots of tasty snacks and even a laptop to show him his favorite program to distract him. none of our props were necessary, but it felt good to feel prepared, anyway. The results came back negative, so it looks like our son is in the clear, and now we won't have to wonder what's going on for him, as we undoubtedly would have if we decided to skip the test. Praise God!
H.O. answers from San Francisco on January 30, 2008
I had this procedure myself, NOT through a catheter but an IV, when I was in high school. (20 years ago). I vividly recall feeling a very warm rush/sensation when the die was injected. It didn't hurt, but made me warm (from the inside out) and a little woozy because of the oddness of the feeling and swiftness of the rise of my body temp.
My hunch with catheters is that sometimes get someone who is gentle and experienced with placing and removing them, and sometimes you do not. (I too have had painful catheters but also pain free catheters) I think providing pain meds to make a child more comfortable would be a good preventitive step if it's offered. Confiding with your Doc your hesitations (they sound like justified concerns!) could help your family address them hopefully. I wish you and your family well with this.
1 mom found this helpful
L.C. answers from Sacramento on January 29, 2008
My son was younger when he had this procedure done and it was without a catheter. I know the procedure sounds horrible, but it is so worth it. If your son's swelling is at grade 1 and 2, it's still not that bad but it's not worth letting it get bad if they can do something to rectify it now. Why risk him having some kind of kidney damage because a procedure may be uncomfortable.
My son went through the surgery to correct his problem and it was so easy and worth it. His kidney swelling dropped from 17% down to 3%. We don't have to do any further ultrasounds and he's off all the medications.
S.H. answers from San Francisco on January 30, 2008
My son who is almost 6 has had to have several VCUG's due to the same problem combined with other urinary issues. I would say despite the discomfort of the procedure, go have it done. It is much easier when they are younger. The results are very beneficial and because things can change so fast in their growing bodies, it is important to monitor this. Were you referred to anywhere in particular? We are seen at the Pediatric urology department at UCSF and they are wonderful!
Feel free to email me privately if you need or want.
M.P. answers from Sacramento on January 30, 2008
Well my son almost died of kidney failure at 5 weeks old and this test is what diagnosed him. We were in the hospital for two weeks because he had a posterior urethral valve causing reflux from his bladder into his ureters and kidneys. If that is what they are checking for I suggest you have it done. If he is haveing reflux it can cause lasting kidney damage and infection.
E.A. answers from Sacramento on January 30, 2008
I had a similar experiece with my son, he was four at the time, now he is seven. He had an infection but apparently it's not common in boys so his pediatrician wanted us to see a specialist right away, (she prescribed antibiotics and my son got better.) However, the specialist wouldn't see him until after he had the VCUG. My husband and I did some research that took us nowhere, until reluctantly we decided that it would be better to have the procedure done and to make sure that he was OK and not take any chances. The day of the procedure he had to have an ultrasound done before to see the kidneys and then the procedure started. My husband and I were there with our little guy and I really don't remember who held me from behind, I almost past out and started to cry. Unfortunately the hospital where we had to take him is also a teaching hospital and one of the medical students tried to do it. She couldn't do it so the assistant called the specialist and he did it. By then I was a mess and my son was in so much pain. He inserted the catheter and the dye and started taking pictures while turning him around in order to look in from different angles. After this ordeal was over we met with the other specialist a few days later and talked about the results. My son was fine, everything came out right and they just had no idea why he had the infection in the first place. We think that the procedure was unnecessary and we didn't have to put our son through that. However the doctors thought the contrary and that's why we did it. I don't know anything about having enlarged kidneys and what would the procedure show. You can see everything inside though. My son remembers everything and he doesn't want to go through that again. Sorry I don't give you much encouragement about the procedure and I really don't know if it's absolutely necessary to go through it. If it is, then he should have it done. My son was a trooper and I survived!
C.B. answers from San Francisco on January 30, 2008
Just wanted to let you know that one of my daughters went through a VCUG last year when she was five and it was terrible for me to watch her scream. I was pregnant at the time and could not stay in with her because of the x-ray but was there when they inserted the catheter. This was a horrible experience to see your kid scream and say "tell them to take it out". She was however ok after the initial pain and she settled down and was fine when they inserted the dye. i would say do not do this unless it is absolutely necessary. Hope this is of some help but I am being honest.
K.J. answers from San Francisco on January 30, 2008
Hello YJL, we went through the VCUG three times now, my daughter is now 9. We discovered she had urinary reflux, which caused the some kidney enlargement. We had to do the VCUG to determine if the condition was getting better or worse, sometimes the kids can grow out of the condition. It was so hard to have my daughter go through this, but to her it was just a matter of getting it done so she could go to the toy store to pick out a prize (yes, I did use the /bribe system, this is a big one and it was worth it). I don't know where you live, we are fortunate to live close enough to Stanford Medical Center and the Children's Hospital. The first and third VCUG were done by the hospital, they were very good with my daughter, excellent in both pre and after care. The took us in a play room, showed us in kid language what was going to be done, made it fun and exciting. This made the day of the procedure a breeze. The first test was done at 21 months. You must do this test to monitor what is going on with the kidney. If the kids don't have intervention if there are issues, later in life this can cause heart problems and kidney failure. For us medically we had to stay on a very low dose of once daily antibotic for years. This too became routine, just a part of life. NOW, years later, we are off of all meds, the latest VCUG showed substantial improvement, min. scaring on only one kidney and no enlargement at all anymore. Reflux went from a grade 3 to a grade 1. Whew, we are on our way now, they expect the reflux to fully correct itself as she grows....no surgery. So, in summary, do the test, it is necessary to have a base line and to monitor what is going on, this test is the only way they can do this. You must avoid any urinary and kidney infections.....and recognize the sign if a bladder infections starts, before it gets to the kidney. The best of luck, request a mild tranqulizer for the baby (maybe one for you too,HA), and it will be over with soon enough, because the grow so quickly.
J.K. answers from Sacramento on January 30, 2008
I am a Child Life Specialist who works with children in a hospital setting helping them cope with medical procedures and hospitalizations. My daughter had a VCUG at age 2 as well to rule out kidney reflux. We requested a drug called versed that she took orally before the procedure that makes them "loopy" and has an amnesia effect. I was allowed to hold her (I was on the gurney and she was in between my legs lying sort of flat with her head leaning back against my chest)for the catheter placement. A child life specialist distracted her with toys and books and all went well. I have also experienced some that have gone badly. In these cases the children come back and are given anesthesia. At our hospital, they are given versed before they go to the procedure so they are not frightened of the anesthesia mask. A child friendly environment always helps, and a Child LIfe Specialist is beneficial. You can talk to your doctor about all of these options.