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.
I.C. answers from Salinas on January 30, 2008
Due to a problem with the valve between the kidneys and the bladder, my eldest son had a VCUG at 6 months and then again at 18 months. It was horrible. He screamed the whole time. I cried while I sang to him and held him still.
Because that kind of reflux problem can run in families, my second son had to have the same test at 12 months. Again, not a pleasant thing.
Everytime I wanted to grab my sons and run out of that room, I remembered a family that the urologist told us about. They had elected NOT to do the VCUG because it seemed so painful. THeir daughter ended up needing a kidney transplant because of the problems with reflux. And as no kidney could be found . . .
Painful or not, it's better than the alternative.
K.P. answers from San Francisco on January 30, 2008
I have three kidneys and as a child suffered from kidney infections. Twice I landed in the hospital. The first time I had what sounds like this procedure done. I do not remember any discomfort with the catheter and the procedure was how they found my third kidney.
H.R. answers from Sacramento on January 30, 2008
Hi~ I am a mother of 3 ages 10,7,and 3. My seven year old dtr tends to get frequent bladder infections since she was about 2 years old. When she was 3 our pediatrician recommended a vcug for her, in this case a vaginalcystourethrogram. My husband and I both were quite nervous. Although I worked in the hospital for many years I was still quite nervous. They did give her medication to make her quite groggy. The procedure appeared to be more uncomfortable than painful and she doesn't remember anything. Although, the results were negative she still has bladder infections and my pediatrician just recently stated, last month, that vcugs are not recommended as much any more. I am not sure if this helped but my experience with this was a good one and like I said my daughter didn't remember a thing. Good luck
T.H. answers from Seattle on April 25, 2010
My daughter is 7 and has always had problems since age 2 with recurring uti's. We did get the vcug done. It wasnt terrible for her because they did knock her loopy with some sedatives which worked so great. We found out that her kidneys worked fine, But she still continues to get them. It could be a tendency that runs in the family, But i Strongly bieleve its because she doesnt empty her bladder fully.It is a good thing to rule out kidney failure and infections first before monituring continued problems however, There are alot of children who get them alot no matter what we do to prevent them. Maybe we have one of those children ourselves.. good luck with baby!
M.W. answers from San Francisco on January 30, 2008
My daughter had this test annually for four years to monitor a urinary reflux condition that presented itself when she started full-day school in first grade (she was holding it and had weak sphincters). We were hopeful she would outgrow this condition, but the tests showed continued urine flow upward during voiding. She ended up having surgery to correct this (one side only, the other side self-corrected). Without this test she might have had to go through unnecessary surgery, taken antibiotics for more time than was necessary (four years is a long time), or suffered kidney infections/kidney damage. In our case, the costs were clearly outweighed by the benefits.
On the costs side, my daughter is now 14 and her only recollection is that it wasn't pleasant, but she didn't find it traumatizing. We handled it in a very matter-of-fact manner, and I think that helped. She had two very bad kidney infections back-to-back (104+ fever and bad flank pain) when all this started, so the idea of keeping that from happening again was a good selling point. At the time, most of her discomfort seemed to come from the embarrassment of having to pee with an audience and a bunch of machines all around. I had a catheter after childbirth as well, and inserting a tube through an inflamed, abused, post-labor urethra (that's why peeing isn't working and the catheter's needed) can be a painful and difficult experience. A sufficiently distracted (take a favorite toy) and calmed 2-year-old would likely be a much different patient--especially if the adults are calm and attentive. My daughter thought it was awkward and uncomfortable--but not painful.
T.D. answers from San Francisco on January 30, 2008
My 7 year old daughter had a couple of bladder infections and was recommended to have a VCUG to determine if the problem was internal or external. Of course my child is older and so I was able to explain things to her, but it was still a difficult decision to put her through some procedures that would involve a certain amount of discomfort or pain. She did have a catheter placed in her and that turned out to be fine. My doctor advised to have pediatric nurses do the procedure as they are really familiar with how to perform it on children. Although, I think there was some initial discomfort as the catheter was inserted, she never made a sound and was completely comfortable once the procedure was done. She had the VCUG done and this only became discomforting as her bladder filled and she felt the urge to pee. Again, she was a trooper and got through it without tears. But it did turn out that she has an incomplete closure between one of her kidneys and her bladder, which was there since birth, but was just not bad enough to cause infections until now. The doctors are hoping that it heal itself over time since it is only on one side and is moderate. In the meantime she is on antibiotics for the next year where she will have to go through the procedure again to see if it healed or not. Her kidneys are not enlarged, but the walls are thickened, so she will have to have an ultrasound again to monitor that. I am glad that we had the procedure done, just so we know what the problem is - but, of course, we still don't know how it will resolve. Of course, it's up to you to decide whether to have the procedure done, but I wouldn't hesitate because of the catheter - just make sure you get pediatric nurses who are experienced with this to insert it. We had this done at the Palo Alto Medical Foundation - they were great!
H.K. answers from Los Angeles on January 30, 2008
My neice had to have this done when she was 3 for an enlarged kidney. She does not remember having it done. My son (9 months old) has had one and will be having another in May. It may seem scary for him and you, but it will be ok. The ultra sound can tell how enlarged the kidney is, but not necessarily what is causing it. Maybe it would be possible to be referred to a Pediatric Urologist and get their opinion. We see one at Stanford Medical Center and they are good at explaining what's going on.
T.M. answers from Sacramento on January 30, 2008
My 4 month old son had the VCUG procedure done when he was 3 months old and he did just fine. Of course, it was uncomfortable for him when they were putting the catheter in but once it was in he didn't seem bothered by it. I would not wait to have the VCUG done, my son has had hydronephrosis since I was pregnant with him and the VCUG ruled out one of the causes, reflux. We are actually taking him in tomorrow for a nucleur medicine test where they inject him with the dye to determine if there is an obstruction. I personally would not wait to have this test done b/c you don't want to take the chance of the condition worsening. I would ask your son's doctor about the fact that they are using dye with this test, from my experience they only put a certain solution in the catheter to fill up the bladder and take a series of pictures to determine if the urine is moving out and back up into the body. I would also suggest speaking with a urologist to answer your questions unless your pediatrician specializes in this. We also gave our son some Tylenol right after the procedure just in case he had some discomfort. Hang in there, your son will do just fine!
J.H. answers from Visalia on January 30, 2008
My son was diagnosed with hydronephrosis when I was pregnant with him. Once he was born he was sent to a pediatric urologist who monitored him very carefully with ultrasounds.
At the age of one it was recommended that he have a VCUG because the problem was not going away on its own. I know he experienced some discomfort with the testing but the hardest part for him and for me was him lying there on the table and not being able to move a lot or get up. He cried, I cried, but we made it through. I trusted his Dr. who was very experienced with these types of cases. He was very reassuring and told us he would not be recommending the test if he didn't think it was necessary. Following the tesing he ended up having to have surgery to remove the obstruction. That was even more difficult, but needed.
If you are not feeling comfortable get a second opinion or see a well respected specialist in pediatric urology. (My son was seen at Loma Linda) Just don't let it go too long, because he can get serious infections or damage his kidneys.
My son has had follow up ultrasounds and everything is functioning properly now. He doesn't have to take any medications either.
Hope this helps. If you have any questions please feel free to message me!
J.S. answers from San Francisco on January 30, 2008
My daughter was getting a lot of UTIs when she was around 4 and they were really concerned since it could be a sign of something wrong with the kidney. They first did an ultrasound which came back normal but they told me that if she got another one they wanted to do the procedure that you are describing. I was kind of surprised at how much they were pushing the procedure too since my daughter is not a good patient at all- she won't even let a doctor look in her nose or ears. It was explained to me that damage to the kidney can spread quickly and be permanent. I think this is why they push the procedure, to prevent this from happening. I can understand your reluctance but I think it's worth considering. Maybe get a second opinion and then decide? Good luck!
D.N. answers from Visalia on January 30, 2008
I am a xray tech, and part of my job is assisting doctors with VCUG's. I'm also a grandmother. I would not even consider that procedure for my grandchildren or anyone for that matter. It is very painful and traumatic for all concerned....except for the doctor I guess. Please reconsider. If you do feel that you need to go ahead with this, there are places like children hospitals that give the child something to make them drousy so that it's not as painful for them. But then, that's another risk. Remember!!!!! It is YOUR child. Do your research. I applaud you for looking into this thus far. My experience with these is the parents go along with what ever the doctor says. If your doctor is bothered by you not doing the exam and by asking questions.....get another doctor! Good luck to you.
N.C. answers from Sacramento on January 30, 2008
My son was only 10 months ols and had what is called intesusseption (sp?)where his small intestine was almost completely jammed up in his large intestine. Needless to say, it was VERY scary for my husband and I to go through with him. There were only two options; enema and surgery. You can imaginehow aweful it must be to have and enema as an infant. My husbadn had to hold his arms down on the table and keep him still while the doctor tried to use the enema and massage his belly with his hands to try to separate the two. Anyhow, we wanted to let them try it that way first because it could have kept him out of surgery. Turns out, it was so far inside the other that the enema was not enough to break it loose. He went into surgery almost immediately and bounced back in less than a week.
I understand your dilema, but I think you should go with the catheter- it might save your little one from more trama. Little ones are so tough- they will get through with your love. Good luck!!
M.B. answers from Fresno on January 29, 2008
I'm sorry I don't know anything about this situation, but listen to your instincts as a Mom. Get a second opinion from a different doctor.
R.P. answers from Sacramento on January 29, 2008
My friend at work just went through the exact thing with her four year old. They did the test and then ended up having to do a procedure as a choice before surgery. She wouldn't recommend the catheter without having some sort of anesethisia (sp). She said it was very painful for her daughter and horrible for her as a mom to put her through it. She might have to do another one in the future and the doc said h could give her daughter something so she wouldn't have to go through the pain.
I hope I made sense. Feel free to e-mail me back.
P.B. answers from Sacramento on February 07, 2008
Our daughter who is now 5 had alot of UTIs as a baby / toddler and they sent us to UC Davis to the Urioligist who also recomended this VCUG to us. After hearing what it was I thougth it was something that sounded like toture, so we didn't allow it to happen. We ended up just watching her carefully for more UTI problems, making sure she got alot of water / fluids to wash out her kidneys,etc..and today is just fine...so I understand your fear - I was the same way. They said Dr knows best, but you have to also trust your instincts and ask around / get a 2nd opinion if you can before proceeding - just my opinion! ;-)
M.D. answers from Fresno on January 31, 2008
My daughter had undergone VCUG when she was about 2 years old. She had tolerated the procedure well. I cannot give you other information, we may have a different scenario, plus, my daughter had a very high tolerance for pain at that time and did not say anything at all. . However, please do whatever you feel is necessary for the well being of your child. My suggestion is to go for it and get it treated before the kidney gets damaged.
R.S. answers from Sacramento on January 30, 2008
I am an xray tech. I have not only performed these on children, i too have had this study done, as an adult. my first recommendation would be to get the u/s. tell the md you would like to assess the system as simply as possible. if there are no conclusive answers, the vcug is very conclusive. yes, it is uncomfortable, yes, he will likely cry, but it is a test that needs to be done. the amount of radiation is very small, they only take several images once the catheter is in place. I guess the nice thing about infancy, is they dont remember anything later in life. :)
I wish you luck. IF you have any questions, please ask me. I have a pretty good knowledge of what you are going through.