Vesicoureteral...what?

Waiting patiently for our turn ...

I don't think there is anything more heart wrenching that watching your baby scream his lungs out while he is being held down on all four limbs while a catheter is being placed and then imaging (x-rays) shots are being taken. This is what we did on Tuesday afternoon. Due to the urinary tract infection(UTI) Baden got a couple weeks ago, we were sent to Primary Children's Medical Center for some further tests and to meet with a pediatric urologist.

To bring you up to speed, about three weeks ago I was changing Baden's diaper and saw that he had blood in his urine. He had been extremely fussy the previous few days and we were perplexed as to what the cause was. He wasn't feverish, hungry or anything else. We knew all of his needs were being met. Up to this point he truly had been the "perfect baby". So I quickly realized this was the culprit for making my baby not so perfect any more. I was able to get right into our pediatricians office. Good thing too as this occurred on a Friday afternoon. I did not want to go the whole weekend without some medical intervention. Our regular doctor was out of the office so we saw someone else. I told him about the blood in his urine and how he had been unusually fussy and seemed to be in pain. I think the Dr. thought I was one of those crazy first time moms who comes in for the littlest little runny nose. Believe me I would not do that! Remember I worked in the ER for over 2 years and made fun of and got mad at people who did that.

Anyway, the Dr. told me it was probably that he was dehydrated and that causes uric acid crystals to show up in the urine which makes it appear pinkish in color. He said that it is very rare for babies to get UTI's and even more so for boys, so he doubted that was what he had. The problem was his diaper was not pinkish. It was a dark red. I kept telling him my baby was in pain and he finally agreed to collect some urine and test it. They have a small collection bag that is taped over the penis and you can then just put the diaper back on and wait for the urine to be collected. So, we went home and waited for Baden to pee. He did and again it was clearly red. Jed took the sample into the doctors office and waited for them to run the test. Sure enough, it was a UTI. Jed said the Dr. sheepishly came in and apologized and proceeded to go over what we needed to do to treat the infection. Baden was on antibiotics for 10 days which did make the infection go away. But not before we had a few very tiring days with a baby screaming bloody murder every time he peed. If you have ever had a UTI, you know how painful it can be. Imagine your only way to deal with the pain or communicate about it was by crying. Yep, it was not a fun couple of days waiting for that medication to kick in and start killing the infection. As a follow up, we went back to our regular pediatrician the next week and discussed what needed to be done next. He was concerned that he got the UTI at such a young age so he wanted us to do some further testing to make sure everything is OK with his "plumbing". Baden had an Ultrasound of his kidney's and bladder at the peds office and that was sent up to PCMC. Then they had us do an imaging test called a VCUG. That is the torture test we had done yesterday. So as the tech was inserting the cath in, we had to hold the boy down so he would not move and touch the area. His legs were wrapped together with an ace bandage and Jed held those down while I held his arms down. Once the cath was inserted, a dye contrast was released and sent up into the bladder. Once that was done the tech was able to take his pictures. Of course by this time Baden was screaming at the top of his lungs. So hard to see and hear! It took about 20 minutes for the tech to get shots of all the different angles he needed, including while he was peeing and while he was not. The radiologist then came in and looked at the pictures and told us a little about what he was seeing and what he recommended for treatment.

On a scale of 1-5, 5 being the worst, Baden is at a 4 for urinary reflux. The medical term is Vesicoureteral Reflux. This means that his case is pretty severe. Basically the valve flaps from the ureters that are supposed to close when urine is passed, do not close. Thus allowing urine to go back up into the bladder and kidney area instead of completely draining from the body. This is happening on both ureter's(we have two). This is what caused the UTI. We met with a pediatric urologist after the VCUG and she said that this is actually pretty common, but is often undiagnosed if kids don't get UTI's and the majority of kids "grow out of it" as they get older. Or better said, the valve flaps grow and repair as the child gets older. Because in most cases the flaps repair themselves, they don't do much for the first year and a half. Baden will be on a very small dose antibiotic until he is a year and a half to prevent further infections. At that time we will go back in and have another VCUG done to see if any progress has been made. If it has not, surgery to repair the problem will be done. It's a pretty routine procedure, but of course we are hoping it doesn't come to that. So yeah, we're good now. No more screaming when he's peeing and hopefully no more infections!