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KUB Scan Shows Hydrouretronephrosis On Left Ureter And The Kindney-ureter Joint. What To Do?

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Posted on Tue, 30 Oct 2012
Question: My son Devnash is 1 yr old and is diagnosed with UTI. KUB scan shows hydrouretronephrosis on Left ureter and the kindney-ureter joint. The dilation of ureter is 11 mm. UTi is being treated by Pecef-100 but fever has come back after 5 days. Doctors suggest hospitalisation followed by IV Antibiotic course. Once UTI is treated, then MCUG can be done. The CRP is 80. WBC count is 0000. Urine Culture shows E.coli with colony count > 0000. with pus cells plenty.
doctor
Answered by Dr. Avinash Ignatius (1 hour later)
Dear XXXXXXX

Hydroureteronephrosis in your son's kidney suggests either there is a block at the junction of the ureter with the bladder or the normal valve mechanism at the junction is affected causing urine to go backwards to the kidney from the bladder. An MCUG will help find out the cause, and there by the treatment.
However doing the test during active infection is not recommended as there is high risk of the infection spreading to the kidney.
If oral antibiotics are not effective, he will need I.v. Antibiotics, before the test.
Leaving the problem as such now has the risk of your son getting recurrent UTI and development of weakness of kidneys in the long run.

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Avinash Ignatius (47 minutes later)
Thanks Doctor for your reply. l
Here's a brief case history:
14th Sept --> He has (no cold/cough) fever that was diagnosed to ear infection.
15th Sept --> Ceprofox for 3+2 days till 20th Sept
16th to 22nd Sept --> No fever
23/24 Sept - Mild intermittent fever. Wiat and watch with Crocin for 3 days
27th Sept --> Blood/Urine reports/cultures asked for. Pecef100 prescribed for 5 days
28th Sept --> No fever
29th Sept --> No fever. Based on urine/blood reports, KUB scan asked for. Pecef increased to 10 days
30th Sept - No fever
1st Oct --> KUB Scan shows hydrouretronrephrosis, Doc asked for continuing Pecef100 and go for MCUG later. No fever.t
2nd Oct --> No fever
3rd Oct --> Fever back, IV Antibiotic & Hospitalization suggested
4th - 6th Oct --> Fever intermittent. With homeopathic treatment fever was gone for 2 days. It is back today.
Hence we need to do the admission on Sunday/Monday. Woe want to wait for the alternative medicine to work for at least 1 more day. My son seems to be doing fine and eating/drinking moderately.
Do we need to rush to hospital immediately or can we wait for 1-2 days at home?
doctor
Answered by Dr. Avinash Ignatius (2 hours later)
Hi,
If your son has no fever, and is otherwise active and feeding well, there is no urgency. However his infection was quite severe as the WBC count had gone quite high. The effect of antibiotics will last for a few days after stopping them.
If there's any residual infection fever and symptoms will appear after the antibiotic is washed out of the system.
Alternative therapies will not take care of anatomical defects. Even if he remains asymptomatic, he should undergo a complete evaluation, rather than wait for another episode of infection.
(Kidney functions deteriorate gradually over time and symptoms appear very late)
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Avinash Ignatius (2 days later)
Hello Doctor,
With Homeopathic treatment,. there has been no fever for last 2 days and my son is seemingly normal. We are awaiting Urine, blood culture reports to get clearance to do the MCUG.

I have attached reports 27Sep KUB, 27th Sep Blood/Urine Reports, 6th OctCUE & latest 9th Oct KUB. Could you comment on the progress of the hydrouretronephrosis to know if in the last 10 days there is more or less of it?

It would help us in taking the next steps.

Regards,
XXXXXXX
doctor
Answered by Dr. Avinash Ignatius (20 hours later)
Hi,

The best person to assess any change in the extent of Hydronephrosis is the radiologist performing the ultrasound. Every image depends on the location and angle of the probe, which cannot be easily noted on a printed image.

However in the images which are attached I do not see a significant difference, in either of those.

The line of investigation and and management remains the same as discussed before.

Regards
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Avinash Ignatius

Nephrologist

Practicing since :2001

Answered : 119 Questions

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KUB Scan Shows Hydrouretronephrosis On Left Ureter And The Kindney-ureter Joint. What To Do?

Dear XXXXXXX

Hydroureteronephrosis in your son's kidney suggests either there is a block at the junction of the ureter with the bladder or the normal valve mechanism at the junction is affected causing urine to go backwards to the kidney from the bladder. An MCUG will help find out the cause, and there by the treatment.
However doing the test during active infection is not recommended as there is high risk of the infection spreading to the kidney.
If oral antibiotics are not effective, he will need I.v. Antibiotics, before the test.
Leaving the problem as such now has the risk of your son getting recurrent UTI and development of weakness of kidneys in the long run.

Regards