hydronephrosis, ds had his ped uro appt... anyone else with this?
CantWait2Be
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ds is 18 days old, his left kidney is enlarged (hydronephrosis) which was discovered at an u/s I had due to gd. He had an u/s in the hospital when he was 2 days old and it showed it's still enlarged. So ped uro has us coming back on July 20th to do another u/s and a vcug (to rule out reflux). I thought she said most cases of blockage (upjo, which she thinks it is) resolve themselves but then the paperwork she gave me indicates most blockages require surgery and reflux usually resolves itself. So i'm a bit confused and definately concerned that my son may require surgery. ds is on antibiotic to prevent infection of his kidney in the mean time. I'm not thrilled with him having exposure to radiation so young but want to get his kidney issue treated/resolved.
anyone else have experience with hydronephrosis?
is there a difference between an obstruction and a blockage?
Re: hydronephrosis, ds had his ped uro appt... anyone else with this?
DS has dealt with this (amongst his laundry list of problems). He didn't have it at birth, but later on. His latest was due to rejection at the ureter, where they thought the blockage was. They thought there may have been something (like a stone) blocking the flow of urine to his kidney (he's transplanted now, so only one working kidney). Turns out that the ureter being in rejection made it swell so much that his urine output was too low and overloading the kidney.
This was something they discovered with surgery because the renal ultrasound didn't show it. He was treated with medication (and antibiotics), and several surgeries, including a ureteral stent and a nephrostomy tube. It took 3 months for it to clear up and his kidney has since healed.
Sounds like the info the uro gave you is correct. Antibiotics in case the blockage is an infection and causing the swelling. If it is a foreign object (like kidney stones), it could come out by itself, or it could need help. If it's reflux, depending on what grade reflux it is, it could correct itself or require surgery.
I wouldn't get too worried yet, the test results once you get them will give the uro a better idea of what is causing the hydronephrosis. Then you can find out exactly how they will treat it. In the meantime (I'm sure they told you this), keep a count on his wet diapers, how many and how much. If it seems like there is a lot less or a lot more, phone the uro. If the colour is dark (like beer almost, or reddish), or smells sickly sweet, phone the uro.
Good luck and hang in there mom! Let me know if you have any questions. And sorry for the novel.
Keeping track of urine output is extremely helpful for the uro. If you have a small kitchen scale (similar to this), you can keep track of how much he's eliminating. Just remember to zero the scale with a dry diaper. What this does is show you if there are any increases, or in his case, large decreases. Keep a sheet of graph paper (or a spreadsheet) next to the scale and keep track of daily averages.
If your ds hasn't changed how much he's feeding, you need to call the uro and let him know because that means he's completely obstructed. You want to avoid complications from that, so tracking urine output is usually a good tool. When they are so little it's hard to see changes straight away, but as they get older, you'll be able to tell if they go less. Keeping track of output is an old habit I have from all the inpatient visits ds has, and our neph. nurse said if I was ever concerned, this is a great resource for them.
Yes, the smell will let you know something is up too. And it really is a strong, sickly sweet smell. The colour is important too, it will tell you when something is up.
As for the obstruction vs blockage, I would think that upjo is an obstruction. For example, where the ureter joins the kidney, if the ureter's opening is too small to allow the normal amount of urine to pass out, that would be acting like a dam and therefore obstructing it's path. A blockage would be like a kidney stone or other object that is blocking urine from exiting the ureter. My ds had a stent put in to make the opening bigger.
I'm not sure if upjo can correct itself, it's possible. I think this is something that they can check via ultrasound, vcug and other types of on your lo. I would think they nornally do surgery, but your uro must have thought it was fine without surgical correction.
Good luck, I hope everything goes smoothly.
DS #1 had this. He had a severe blockage in his left ureter (no reflux, VCUG done a couple days after birth) which required surgery. They basicly removed the blockage and put the ureter back together. They put a stint in while it healed and then removed it through his penis (asleep of course) DS #2 has this as well but far less severe. DS #1 is perfectly healthy and only requires a yearly followup at this point. It was definately much harder on my DH and I than it was on DS. He wasn't even a year old when he went through this so he doesn't remember. He also was on antibiotics to prevent infection. He did have a couple of infections after surgery while not on antibiotics due to a combo of stint and not being circ'd. Ped Urologist did circ when stint was removed.
PM me anytime and good luck.
Sorry for the late response. His surgery was called a left pyeloplasty. The surgery took approx 2-3 hours. He was hospitalized for about 3 days. The first day after surgery he was pretty much in and out of sleep. He had a small tube for drainage that came out of his side which was pulled out before we went home.They gave pain shots in the area so he wouldn't feel anything for a few hours. They gave him Tylenol with Codine for pain and to keep him comfortable. They also had morphine which we tried once which did seem to take his pain away but I asked them not to give it to him again because his sleep seemed restless. Babies and kids heal quickly and also anestethia wears off quickly unlike adults. It honestly was way easier than I had expected. He was basicly back to his old self after the first day. I believe he was more uncomfortable from iv and drain, from being out of routine, and being woken up so often for vital checks. He had to go back a couple months later to have the stint removed which was done while he was asleep. It took minutes. Urologist pulled it out from through his penis. As for actual site, it healed quickly. It is about an inch and is on his left side. It has healed great and is barely noticeable.
Good luck. PM me with updates or questions!!