question-icon

Suggest treatment for UTI and acid reflux in a child

default
Posted on Sat, 7 May 2016
Question: My 1.6 yrs baby has urine track infection. She has grade 5 reflux. Is operation is necessary immediately?
doctor
Answered by Dr. Deepak Patel (48 minutes later)
Brief Answer:
Operation is mandatory

Detailed Answer:
Hi,
Welcome to HCM.
Can understand your concerns.
It's really unfortunate that you are dealing with this problem.

There are some studies which says that antibiotic prophylaxis should be given in grade 5 vesicoureteral reflux but it is usually seen that surgery is required in almost all cases and prophylaxis has very limited role.
Operation is done in vesicoureteral reflux to prevent kidney damage. If you don't do the operation then there are chances of kidney damage.
In my opinion you should go for surgery without hesitation as this is the only option available.
I hope this will help you.
Take care.
Above answer was peer-reviewed by : Dr. Naveen Kumar
doctor
default
Follow up: Dr. Deepak Patel (1 hour later)
Thank you Doctor.

Please let me know if the immediate operation is Necessary or else we can wait till she becomes 2+ years old. she is now 18 Months and we are giving daily antibiotic - Bactrim.

After first episode of Urine track infection while she was one year old, since then we have started daily dose of antibiotic. Since then she is well and no Urine infection detected.

DMSA scan results some scratch on lower pole of right kidney.

we should do the operation immediately in this case or we can wait for another 6 months.

thanks;
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
doctor
Answered by Dr. Deepak Patel (9 minutes later)
Brief Answer:
Immediate surgery will be a better option.

Detailed Answer:
Hi,

It is nowhere mentioned about the exact age of operation.
However, in grade 5 reflux if scarring is present then operation is the most preferred treatment option.
In your child case grade 5 reflux and renal scarring both are present.
The only positive thing is that she doesn't have febrile urinary tract infection.
In my opinion, operation will be a better option. However, this depends on the operative surgeon as things might be more clear to him.
Take care.
Above answer was peer-reviewed by : Dr. Naveen Kumar
doctor
default
Follow up: Dr. Deepak Patel (21 hours later)
Hello Dr. XXXXXXX

As per the suggestion, we will do the operation immediately. She was on daily antibiotics-Bactrim Syrup till now since last 6 months. We did her regular Urine check up and didn’t found any symptoms of Urine Track Infection. In between couple of times she has fever but that was due to cold.

Currently also she has fever 101.7 & she seems to have a bit cold as well. We will do her urine test again tomorrow. Doctor suggested giving her Relent syrup & Ibugesic Plus syrup for now. Tomorrow we will see her Urine test result and will see if she is again infected with UTI.

We want to know if after the operation also are there any chances of Urine track infection and can the renal scar can be cured further. Do we need to any other treatment to cure her renal scar present?

And also the operation will be simple or critical?

Thanks;
XXXXXXXXXXXXXXXXXXXXXX
doctor
Answered by Dr. Deepak Patel (41 minutes later)
Brief Answer:
Surgery opinion will be better.

Detailed Answer:
Hi,

Sir, as you know that this is a surgical procedure so a surgeon will tell you in a better way about the outcomes.
We usually refer the patient to surgery after medical line of treatment for 3 months.
As per my knowledge, open surgery has 98 percent results and endoscopic surgery 84 percent. However, complications are less in endoscopic surgery.
Scarring once occured doesn't become well so you should not think about it but about saving other portion of kidney.
I suggest you to take a surgeon's opinion about this.
The only thing that we want in child is normal kidney function and gfr (glomerular filteration rate).
Endoscopic surgery is more safe than open surgery in terms of complications.
I suggest you to go for surgery. If you don't go for surgery than chances of renal failure are very much.
Wishing good health.
Regards

Above answer was peer-reviewed by : Dr. Naveen Kumar
doctor
Answered by
Dr.
Dr. Deepak Patel

Pediatrician

Practicing since :2000

Answered : 1304 Questions

premium_optimized

The User accepted the expert's answer

Share on
Suggest treatment for UTI and acid reflux in a child

Brief Answer: Operation is mandatory Detailed Answer: Hi, Welcome to HCM. Can understand your concerns. It's really unfortunate that you are dealing with this problem. There are some studies which says that antibiotic prophylaxis should be given in grade 5 vesicoureteral reflux but it is usually seen that surgery is required in almost all cases and prophylaxis has very limited role. Operation is done in vesicoureteral reflux to prevent kidney damage. If you don't do the operation then there are chances of kidney damage. In my opinion you should go for surgery without hesitation as this is the only option available. I hope this will help you. Take care.