nice surprise
Nolan has had several infections which were thought to be UTIs though the last sample they took was “contaminated” so it wasn’t clear what was going on. Because UTIs are so rare in boys his Pediatrician wanted to have some tests done to see if he was having reflux. There are cases where the urine refluxes all the way back up to the kidneys and can damage them which can require surgery.
The first test was a simple ultrasound which went fairly smoothly. The next test was a series of x-rays plus a test where they catheterized him and filled his bladder to see the path of the urine. This test was traumatic for everyone. Two nurses tried to cath him which had him wailing and us ready to walk out. They were able to call his Urologist (Dr Bukowski) down who talked to us about why he thought the test was necessary and then was able to put the catheter in in a matter of seconds. After that things were better and the test was over fairly quickly.
It looks like he is having a very small amount of reflux which Dr Bukowski said is nothing to be concerned about. He also said there are no strictures from the surgery and he didn’t see any signs of a fistula which is a common occurrence after surgery to fix severe cases of hypospadias. This was a nice surprise as we have been expecting Nolan to need surgery this fall ever since his last surgery. The Dr said a fistula can occur at any point so it doesn’t mean Nolan is fully off the hook but it makes this fall and winter a much more pleasant time.
His pediatrician seemed more concerned with the small reflux because of Nolan’s UTI history so we had another conversation with Dr Bukowski. He had another look at Nolan’s x-rays and was clearly unconcerned about the amount of reflux, he said it was within normal range. He also said that the tests we had used to diagnose Nolan’s UTIs were not reliable, that maybe one in 10,000 were uncontaminated so that, yes, he had some kind of infection but the source was unknown. There are two ways to test for a UTI, we have been “baging” him where you put a bag over all the necessary parts and capture the urine to test it. The other choice is to use a catheter which is apparently the only way to get a clean sample but is hard to do, painful and traumatic for all of us. So. Next time…? let us hope there is no next time.
In any case we are looking at a fall with no known surgery, cooling temperatures and maybe if we are lucky a bit of snow. Sounds great!
Saturday, November 1, 2008 at 1:11 pm
Yeah, I can’t imagine that bagging anyone would give a clean sample, but I can’t imagine choosing a catheter either. Maybe he should learn to pee on command before he learns to talk! So I’m celebrating a time without thinking about surgery with you. Hurray! Hope everyone else is healthy too.