Catheterization for UTI diagnosis

For the last few days, I've sometimes noticed some foul smelling urine in Sabrina's diapers (sometimes to the point that I thought the diaper would be more than just "wet"). So Gene and I took her to the pediatrician this afternoon. I told them I suspected a urinary tract infection based upon the smell data plus this morning she grabbed at her diaper area and said "Ouch". The doctor (not our usual pediatrician, but one of the other in the practice) explained that the only way to get a "clean" sample to test was to catheterize Sabrina.

Wait, what? Catheterize my baby??? That was a hard pill to swallow. Harder still was having to watch as one nurse held her legs back and the other tried unsuccessfully for about 1 minute to insert the catheter while Sabrina cried inconsolably (so hard at times, she was running out of breath). Finally the nurse found the hole and some urine went into the vial-looking container. After a few minutes, which we spent consoling Sabrina and telling her what a good job she did, how courageous she was, the doctor came back into the examining room and said they did find blood, which means she does have a UTI and will need to go on antibiotics. Additionally, she needs to come back in 1 week to retest; apparently they can try to catch a sample by using a bag first and if that sample comes back anything but clean, they have to catheterize. Ugh.

They also ran a cultures test on the urine and found that it came back "positive". THIS means that she needs to be tested for a condition called vesicoureteral reflux (VUR). VUR is a condition that 30-40% of babies/toddlers with UTIs have. In kids with VUR, urine from the bladder backs up into the kidneys. Here's the catch -- the tests they do to test for the presence of VUR are a renal ultrasound (okay, Sabrina and I can handle that) and a voiding cystourethrogram (VCUG), which will show whether urine is backing up from her bladder into her kidneys. During a VCUG, X-rays are taken before a catheter is inserted into the bladder through the urethra. A liquid dye is put into the bladder through the tube, and more X-rays are taken to watch the dye as the bladder fills an as she urinates. Sheesh - poor Sabrina :(

So these 2 tests are scheduled for Friday 11/20/09 at a local hospital. I'm praying and praying hard that she falls into the 60-70% that do not have VUR. More to come once we know more...