Having a VCUG Done.

My daughter has had this performed twice. The ultrasound that is sometimes performed first is actually not scary or invasive at all. However, the VCUG is no fun. At Children’s in Waltham, I was allowed to stay with my daughter essentially to hold her down and comfort her while they inserted the dye. When the scan was finished and I picked her up, let me tell you she was MAD. And my daughter's personality is ordinarily extremely laid back. She had the VCUG done at 3 months and again around 14 months. At 3 months the results showed that that one side was a "3" and the other a "4" and that her uters where on the short side but according to the first reading there was no kidney damage. The second scan at 14 months showed improvement and "same as first scan - minimal kidney damage" Because of the mixed readings my pediatrician requested that I keep her on prophylactic antibiotics. Honestly my daughter likes her Gantrisin, but I feel uncomfortable having her on long term antibiotics, particularly where she's using the potty about 50-70% of the time. I feel like she is now better able to communicate with me and I often end up helping her onto the potty and watching her go. I feel like I’d know immediately if she had a UTI. I don't regret using the antibiotics in the first year. With regard to another VCUG, I’m on the fence. I’ll have to discuss that with the pediatrician but I intend to ask if we could try to get by without it, only scheduling the scan if she has another UTI. The one good thing I can say about the VCUG is that it’s fairly quick, a few minutes and you’re done! Best of luck.

Both my girls had this reflux and had to have this test several times. To be honest, it is invasive and they won't enjoy it, but the doctors and the techs were all really great . I bought them each a special toy and did not show it to them until right before the test. This did distract them a little. It can be tough for the mothers to watch, but just keep in mind that this is for her own well being. Good luck.

My daughter also had this procedure done at two years old. While it was not very pleasant she was able to get through it. I was able to stand at the top of the table and get right down in her face so I was all she could see. This seemed to calm some fears. As the test went on she was able to look at the screen the doctors were looking at. While not interesting it was a distraction. I wish you and your daughter the best of luck.

AHH be carful about invasive tests J.!. I am a health counselor and I tell you to start supplementing with probiotics (good bacteria) and eliminate sugar/white flour from her diet. I would consider taking her to a naturopath ASAP. Look to alternatives before going to invasive surgery, UTI's are most likely related to diet.

My granddaughter was 3 weeks old when she had her test. She had an extra tube that caused the reflux. She had surgery when she was a few months old. So far she is fine but she has had to go to Childrens for rechecks a few times. She is 5 now and I think the next and last one is when she is 12. Because of the reflux her kidney is smaller and has to work harder but its slowly catching up. The doctor said it genitic so any child born after her should be checked. I wish you both luck.

My daughter also had an UTI at two years old and the doctor wanted to do the same test on her and I said NO. It was her first (and only UTI). I wouldn't put my child through that kind of procedure because UTIs weren't a recurring problem with her.

I've had three girls go through VCUG and RNC. Two out of the tree have reflux. Having a UTI has nothing to do w/ the reflux. The problem is if they get a UTI w/ the reflux they will be damaging their kidneys. Definately worth finding out if they have the reflux.

A child life specialist at Children's helped talk with the older girls (2&3) and were especially helpful during the procedure helping to keep the baby as peaceful as possible. The quicker they are able to release the better and less thime it takes. They also had a tv screen and the girls were able to pick a video to watch which helped to distract a bit.
They are doing research now and looking for less invasive ways to test.

Luckily for us one has outgrown her reflux and we will be retesting the now 18mo old in hopes that she too has outgrown it. Good Luck

My 19 month old daughter just had a VCUG and a renal ultrasound done just this Monday at Childrens (because of a UTI as well). They kept telling me it wasn't painful, just uncomfortable for her. She isn't a fan of the doctor in general, so we knew it wasn't going to be great. I don't want to upset you, but I wish I was better prepared for it. It was a very stressful and traumatic day for all of us. Make sure your husband, mom, or friend can come with you. She kicked, screamed, and fought it the whole time. It took both my husband and me, along with two nurses to hold her still. I stayed by her head and put my face against hers and kissed her and sang her songs the whole time which seemed to calm her a tiny bit. It was very scary for her.

Then she had an allergic reaction to the contrast dye, so watch for signs because the doctors and nurses didn't see it--I did. They were wonderful at Childrens and were very kind, gentle, and patient--with mommy and baby!

The good news is that she showed no signs of abnormality or reflux and it was a common UTI(the doctor told me that it is very uncommon and most kids are fine--so that is good news, right?)

Good luck!

HI J.,

My son had this procedure done a month or so ago, he's 9 months. I don't believe the procedure itself hurt him but he had to be held down by the arms and legs so he cryed alot. They have to put a cathiter in and then inject fluid. This is all done under an xray that is why they have to lay still (be held down). Once they injected the fluid a few times to watch the flow he pee'd out the cathiter and the fluid. The minute it was out and we could let go of him he was fine and didn't cry anymore.

With her being older you may not have to hold her down as much. I hope it goes well for you and your daughter.

S.

On my, unless your daughter has had CHRONIC UTI's, please don't do this! There is no "happy and comfortable" with VCUG. The catheter is very painful, not just "uncomfortable". Our first pediatrician recommended this procedure/test and it was so traumatic for my the 5 year old daughter. I wish I hadn't allowed it. I got a new pediatrician, added cranberry and yogurt to my daughter's diet, bought fragrance/dye free toilet paper, switched to all cotton underwear, re-taught her how to wipe properly, and THAT was a huge help. Again, I cannot stress enough, this procedure is painful and should be very carefully considered.

Hi J.,
I had to have it done on my daughter right before she turned 1. I had it done at Hasbro/ RI hosp and the staff was wonderful it really helped having nurses and doctors that cared. They allowed me to stand at the head of the table so I could hold her hands and pat her head. While it was going on I sang to her and talked about some funny stories the nurses even joined in the singing which helped alot. I did have to hold her hands tight when they put the catheter in but once that was done she didn't really notice anything was going on and just layed there singing. I think they even allowed her to have a drink while it was being done. It was a lot easier then I expected and quicker. I was really on the fence about doing it and decided to have it done b/c of the type of bacteria that was causing the UTI. I went in very protective and defensive and realized I had no need to be. Leading up to the appt. we didn't talk about it or tell her she was going we just got up early that morning and went and she was fine no nerves and no anxiety from anticipation. Good Luck

Hi J.,

My first suggestion would be to call the hospital and request a child life specialist. This is someone who is trained in child development and works with children and families to help prepare for medical procedures. This person can give you a play by play run down of what will happen so that you can try to prepare your daughter. She will hopefully be available at the hospital to work with you and your daughter prior to the procedure and offer support/distraction during the procedure. I myself am a child life specialist but I do not work in radiology so I have only helped with VCUGs a handful of times and the children were older.

Having been in the field for over 13 years I do suggest that you bring both comfort and distraction items for your daughter. I also suggest that you try not to show any anxiety in front of your daughter. Children pick up a lot from their parents and if you are nervous and anxious, your daughter will be too.

For most children this age, no matter the procedure, the hardest part is having to be held down. If she can hold still on her own (one can dream!) than this won't be an issue. She will have to lay down with her legs spread open, bent, and feet touching...some people like to call it frog legs. You can practice this position before hand so she knows what to expect. You can even use one of her dolls to show her. Once the catheter is in (depending on the tech), she can probably straighten out her legs some.

As for whether or not the test is even necessary, that is up for debate. One of my best friends is the child life specialist in radiology at Mass General and all she does for the most part is prepare children for VCUGs. She says that they have had instances where the child only had one UTI and the test showed that there was reflux so you never know.

Lastly, some places will sedate young children if they cannot hold still. You may want to call and see if your daughter can have an oral medication to hlep make her a little sleepy. I am not a big fan of medicating children unless absolutely necssary but that is an option.

I know that was a lot but I hope it was helpful. Feel free to contact me if you have questions.

Good luck!

My daughter had infections and strong odors and pain when urination whenshe was about 2-3. My pediatrician told me to make sure we were not washing her hair in the tub and rinsing her hair there becasue that causes alot of similar symptoms to reflux/UTI as soon as I stopped the hair rinsing inthe tub all problems stopped.
--Good luck,
ClareW
www.MyHomeCottageBiz.com

My oldest daughter had the problem with urine refluxing back up to her kidneys when she was a little infant. As she is now 21, I do not remember this test specifically. The reason we found this problem was because she developed a very high fever over a weekend. When I called the pedi's office, they sent me to Children's Hospital in Boston. She had to be hospitalized for a few days in Boston on IV antibiotics. She then took Bactrim for probably about two years following this as a preventative. She eventually outgrew the problem.

My second daughter was born with special needs. She underwent heart surgery when she was 5 months old and various other surgeries and procedures and hospitalizations.

It is very difficult to see your baby have to go through tests and procedures. At two, I don't think there is anything that will truly keep her "happy and comfortable." Just be there and be as comforting and reassuring as you can. You cannot get upset as she will pick up on your emotions. The doctors and nurses do these procedures all the time and are experts at getting you through this as comfortably as possible.

Hi J., My foster son had to have a VCUG at about 4 weeks old. When they explained what they were going to do I was horrified but the actual procedure was very quick and I think it was worse for him to be held down on the table then the actual procedure itself.
Good luck!

Hi J.,

My son has had this test done before at Children's in Boston. They were WONDERFUL with him and me. It is invasive, and somewhat uncomfortable, but it is over quickly. With my son, I leaned over him and hugged him while they did the test. I tried to just stay calm and not freak out. I just kept reminding both of us it would be over soon. I sang songs with him, and talked about what we would do when we left (like go get an ice cream.)I kept my voice quiet. I had to remind myself that it was unfortunatly necessary to make sure that his reflux was improving. He had a UTI when he was 11 weeks old which was very very scary. He was a 4 on a scale of 1-5. The biggest thing was to stay calm. He did cry a bit, and so did I. He was a little sore for about a day, but the good news was his reflux was gone which meant no more septra! He was three when he had the test done, and is now 5 with no problems. Hope this helps. Good luck.

Yes, we have had many a VCUG (and other tests so I get quite confused). My daughter (now 4) was "replumbed" robotically at 1 1/2 years at Children's in Boston. The staff is quite good at trying to keep the kids busy (videos, etc...), but your daughter is young so brace yourself.... The worst thing is the catheter which doesn't hurt as much as it's a new sensation. They will fill her bladder with liquid while she lies (hopefully still - ha-ha) and they take pictures of her from underneath (after she empties her bladdder). The hardest thing is making her pea on cue (or at least it was for my daughter but it's easier when they are not toilet trained). You will be able to stand next to her, holding her hand, whatever.... I think that's the test if they've said it was "invasive." I don't consider this an invasive procedure, except for the catheter, but it will be h*** o* you guys. Try to be loving and matter of fact. Kids sense when their parents are uptight. They will let her pick from a toy treasure box afterwards. We always buy our child a balloon from the gift shop, too. Kids are unbelievably resilient (unlike us parents - you should see my gray hair!). You should have the results immediately from the doctor. If your daughter is having an "off" day, consider scheduling the office visit for another day because sometimes the wait can be quite long. You may even be able to get the results by phone or e-mail. Unless there are other concerns, they really don't need to see the child. After three years of antibiotics, we were pronounced "reflux free" last March. Hang in there. Feel free to e-mail me privately if you need a shoulder. God bless your little girl! P.S. As a precaution, they might ask to screen your other child by ultrasound, too!

My daughter ended up having a UTI at 6 mos old (we discovered this because she had had a fever on and off for 3 days and on the third day I realized her urine smelled funny to me and we had it checked). We felt very blessed to have found out so quickly and that the UTI had not done any damage to her kidneys. It's tougher to give advice here since your daughter is older than mine was and may be able to articulate her fears of having this strange procedure done. However, my recollection (and it was 7 years ago) was that it didn't last too long, we were there the whole time and it was more uncomfortable than painful. And the results are so important to find out if there is reflux and how far up it goes so she can get the best solution. Ours was simply a daily dose of medicine for a year until her valve grew enough to stay closed. Maybe you can offer to do her favorite things that day for being so brave. Good luck!

Hi J.,
I agree with the other moms- this test is NOT necessary if this is her first UTI. Kids get UTI and don't have reflux. My son had hydronephrosis prior to birth so we knew there was a strong possibility that he had reflux. His was diagnosed at 6 weeks old via VCUG. He did great then, and we fed him sugar water that really kept him occupied- he didn't seem to notice the catheter at all. He had a repeat VCUG last month (12 months old) and it was a nightmare. While I am sure he wasn't in any pain, having to be held still and pinned down was very tramatic for him.

Your girl is 2 already. If she has reflux, she would have probably already had UTIs before now. Treat the infection, and adjust her diet a bit. Add probiotics to your routine, or even feed her yogurt often. (you should do this anyway, especially since she is on antibiotics for the infection) Personally, I think VCUG after one infection is overreacting a bit. Unless it becomes a chronic problem, I think you should not do it now. Of course, if you really 'just need to know' then do have it done. You know her disposition. If you think she will fight laying still and being held down, talk to your doc about giving her Versed. It is a liquid drink that makes kids a little dopey and sleepy. She won't even remember the test later. If you think you may want this, do ask about it ahead of time so they know to have it ready for you. Good luck.

Hi J.,

My oldest daughter had that test done when she was 2 1/2. She had a uti and the dr wanted more tests done to test for reflex. She did end up having a mild case of reflex in the bladder and was on antibiotics for a year. It is a hard test for them to go through. We had it done at children's hospital in boston and they were great. They had a woman that explained everything in kid's terms and was there through the whole procedure. They had videos to watch to help. My husband and I were both there to comfort her. One thing I can say is that it was fast. It was uncomfortable for them during it but once it's over she didn't have any pain. She had to go through it again a year later to make see if she had outgrown the reflex and she did. Thank god. Good luck.

My son had that done when he was a month old. He had hydronephrosis (enlarged kidneys)that was detected while he was still in utero. They recommended a test that really wasn't needed after all because it resolved on it's own.We had to sit and wait in a room full of people until he peed and then they monitored whether his kidneys had reflux. I would say that I would only recommend the test if she has chronic UTI'a as you have to hold your child down and it was somewhat traumatic for all involved-although a relief to find that his kidneys were fine. I wish you the best of luck

My daughter (now 5) had this done at 16 months. Unfortunately, there really is nothing you can do, but it doesn't take too long. They inject a dye into the bladder and fill it with liquid and then you wait for her to pee. Unfortunately, it took my daughter a while, and she cried the whole time. I had my husband hold her while I stayed behind the glass so I wasn't exposed to the xrays they use to check the reflux. It's no fun, but she came through it just fine, just cuddle her and give her a treat afterwards. It's much worse for us parents than for them. It doesn't hurt, it's just that she can't move, so depending on how long it takes her to pee, she's just frustrated, in no pain. Good luck!!

Mom to a healthy 5 yr old girl and 2 yr old boy.

both of my girls who are now 8 & 5 yrs old, had kidney reflux. Both have grown out of it. my older daughter was between 2.6 and 3 yrs old when we discovered it. I think the first time we had her tested was pretty easy. The second year was a little more difficult only because she was more conscience about being potty trained. The dr's and nurses wwere always so sensitive and supportive to the kids, it helps them feel ok about what's going on.