2 UTIs on Bacterium - Pediatric Oncall

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	Specialist Answers
Question
My 3 year old daughter has VUR. It was diagnosed very early and she has been on antibiotics. For the past two years, all was well but then she got two UTI's one after the other. It was so bad that she couldn't even urinate. I asked the doctor if it was possible that she built a resistance to the bacterium and I was told that it was very possible. I want to know if surgery would be better for her and if so what is the surgical procedure like? I would appreciate any info you could forward. Thanks.
Answer
Since your child has had 2 UTIs on bacterium, what would be necessary is to know the organism causing the infection (by a urine culture) and change the antibiotics( long term prophylaxis) accordingly. Surgery is recommended only if the VUR is severe that Grade 4 or 5 and causing kidney damage. The surgical procedure done is reimplantation of the ureters (the tubes connecting the kidney to the bladder). Has a renal scan been done in her? If no, then a DMSA scan should be done to find the extent of kidney damage and if the kidneys are not scarred, then long term antibiotics should work fine. Also the decision for surgery has to be taken together by the nephrologist and the surgeon to weigh the pros and cons and decide what is best for your daughter. In the meantime read the article on "VUR" on www.pediatriconcall.com or from the link given below: http://www.pediatriconcall.com/forpatients/CommonChild/Kidney_problems/ vur.asp Back to All Questions

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