What is your diagnosis?

10 years male child. 

Febrile event before 3 months. 
UTI was detected first time before 3 months. On ab prophylaxis since than.
Severe constipation 
Voides at time with difficulty. 
Post void residual in two USGs different.  Last USG 30 cc pvr 
Urine culture positive 
S. Creatinine: 1.1mg%
Urine protein absent 
Focal neurological examination normal 
USG, VCUG AND MRI WERE DONE elsewhere. Postings immages for review. 
Please discuss possible diagnosis. 

What is your diagnosis?What is your diagnosis?What is your diagnosis?What is your diagnosis?What is your diagnosis?


  • Dr. Roy Chally
    Dr. Roy Chally
    02 Dec 2020 08:00:28 AM

    Paediatric neurology opinion ?

  • Dr. Roy Chally
    Dr. Roy Chally
    02 Dec 2020 08:04:51 AM

    Voiding dysfunction with severe constipation needs Paediatric neurology opinion.  Cystoscopy findings and ? CMG findings? 

  • Dr. Anil Takvani
    Dr. Anil Takvani
    19 Dec 2020 09:19:47 AM

    @ Dr. Roy Chally Sir, 

    I am extremely sorry for late response to you query.
    Cystoscopy: Urethra normal. No posterior urethral valve. Bladder neck little elevated. Capacity of bladder almost 300c under G.A. Bladder grade one trabeculations. Bilateral ureteric openings placed little lateral, wide open, accepting 6F or wider instrument easily.
    We worked on his fluid intake and output issues. As usual child was instructed to take plenty of fluids at other places, was attempting 6 to 7 CIC with failures. We worked on intake output charts, now daily output is less than 800 cc. He is doing three time catheter emptying.
    On his last follow up: S. creatininne: 0.76 mG%, Upper tract stable in USG. There is still issue of UTI.
    I am planning his video-urodynaemics once the UTI is reasonably under control.
    We don't have pediatric neurologist but neuro-physician opinion is taken. His comments: no active intervention from us.

  • aditya gupta
    aditya gupta
    28 Jan 2021 12:26:27 PM

    please correct me if i am wrong:

    bowel bladder dysfunction secondary to spinal issues:disc herniation and stenosis.
    creatinine post cic is .76, b/l gross hdun with thinned out parenchyma and scopy was normal..
    patient in future will need transplantation i feel. cic though a good option will lead to urethral problems in future: stricture, inflammation, infection particularly epidydymo orchitis: which might hamper later transplantation, fertility. so a mitranoff procedure can be a better option in this atleast till then..?

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