VUR IN 5YEAR FEMALE CHILD

• 08 Jul 2020 07:59:47 AM
• |Pediatic Urology

5YR FEMALE CHILD PRESENTED WITH RECENT ONSET UTI. TWO EPISODES OVER A PERIOD OF THREE MONTHS. CULTURE HAD SHOWED E COLI SENSITIVE TO MOST ANTIBIOTICS.

Comments(4)

• 

  Dr. Anil Takvani

  08 Jul 2020 08:23:40 AM

  As her age is 5 years, you can have following things for sure in your clinical history and in investigations:

  1. Any voiding issues like low or high frequency, day or night time incontinence and holding or postponing maneuvers?

  2. Constipation?

  3. Post void urine in USG?

  4. Uroflowmetery?

  All these thing will give reasonable idea about recent underlying bowel and bladder issues if any.

  PVR and uroflowmetery with intake/output diary in toilet trained children is non invasive way of getting information of bladder dynamics.

  If BBD is there treat it along with AB prophylaxis for 3 to 6 months. If breakthrough infection/infections will go ahead with correction of VUR either by injecting bulking agent or by reimplantation.

  If possible upload images of VCUG and DMSA scan.

  Thanks for posting a very useful VUR case...

  
  

  
  

• 

  Altaf Khan

  08 Jul 2020 07:42:04 PM

  Dear Dr Anil,

  Thanks for your suggestions.
  

  There was no history of voiding issues or constipation. Post void urine was hardly 5ml. I haven't done Uroflowmetry.

  I have started her on antibiotic prophylaxis.

  My plan was to inject deflux if breakthrough infection.

  Will upload VCUG and DMSA soon.

  
  

• 

  Altaf Khan

  09 Jul 2020 03:55:16 PM

  How long to continue Antibiotic Prophylaxis if there is no breakthrough infection?

  View Document

• 

  Dr. Anil Takvani

  11 Jul 2020 01:35:07 PM

  In this case will give it for 3 to 6 months. After that stop AB prophylaxis. During this 3 to 6 months period will focus also on voiding & constipation issues.

  If breakthrough infection or new infection after stopping AB prophylaxis, will consider her for definitive treatment.

  Thanks