Question of the Week

Question :
Posted On : 22 Nov 2018
I am willing to consult with you about my son who is
A 2 year and 3 month old boy suffering from Posterior Urethral Vulve.
He has two documented UTI age age of 11 month and 2 year 1 month
His serum creatine :0.6mg, dl{at age 1 year 6 month}
:0.4mg, dl{at age 2 year 2 month before operation}
His USG KUB done twice at age of 11 month and 13 month-with in normal limit.
DMSA scan done at age 13 month -within normal limit.
DTPA scan done at age 1 year 7 month- Report: Both kidneys are of average size and shape with normal perfusion and normal cortical function with no obstruction in either kidney. Total GFR:114.14, Differential function:Left kidney-46.67 percent Right kidney-53.33 percent.
MCU done at age 1 year and 6 month-Report:Posterior Urethra is dilated with residual urine in bladder but no reflux.Cystoscopy done by pediatric surgeon and according to him there no typical posterior urethral vulve.
MCU again done at age 2 year 2 month with no improvement in MCU report. Again cystoscopy done by another pediatric surgeon. According to surgeon`s note posterior urethral vulve found and fulgurated at 5,7 and12 o`clock position.
Baby`s urinary flow is improved after cystoscopy 2nd time.He is under antibiotic prophylaxis.
I am interested to know about his further follow up and prognosis.
Expert Answer :
Dear Sir, Madam
From the history and investigations you present it would appear that you son is still prone to developing UTIs. The imaging studies do not show signs of severe obstruction or reflux and his GFR is stable. At this stage I will follow-up every three months with a urine MCCS to ensure that he dones not have silent UTIs and if after a year all is fine you can do this every 6 months. I will also monitor his kidney function and if stable this can also be done 6 montly.

Hope this information is helpful to you.

Warm regards
Answer Discussion :
No answer discussion available.

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