UTI and Intact Friendly Doc

[Cheshire]

My 4 yo has a UTI. He's about to start his fourth round of antibiotics. Our ped says it is the same bacteria and she's trying all the antibiotics that are specific to it (E. coli).

We had an ultrasound done on him and his bladder, kidneys and everything measured right on - nothing abnormal. She'd like us to see a urologist in case it is related to his being intact. When the nurse called to tell me this I asked her if the urologist practice she was recommended are foreskin friendly. She said she didn't know but I could ask when I called. She said they would have special instruments to see if he has a stenosis???

I told her I didn't want to take him to a urologist that would recommend circ because we wouldn't chose that course. She said even if they did recommend it that we didn't have to take their recommendation. Um, yeah. UGH.

So, I need an intact friendly ped in the Dallas Fort Worth area that wouldn't even consider circ'ing.

I'm so frustrated because I feel like we haven't cleared up the original infection. I actually would like to talk to urologist more in depth about this bacteria and why the antibiotics haven't worked but I sure don't want to have to fight with one over retracting at the exam. More than anything I want one that will help me find a solution instead of thinking we're nuts for keeping him whole.

Any recommendations??? Even if it is just an intact friendly ped or family doc.

[Fellow Traveler]

A possibility

We've got a list and this one is on it. I don't know the source of the specific recommendation though.

Leslie McQuiston, M.D. Pediatric Urology
LocationsFTW Downtown Pediatric
1325 Pennsylvania Avenue Suite 550
Fort Worth Tx 76104 [phone]
[phone]

Also you might want to make a call to NOCIRC for a referral too. And check your PMs. If you go to him/her, or someone else, please report your experience.

[Cheshire]

Thanks, Jwhispers, will do!!!

[latinalonestar]

Originally Posted by Cheshire

My 4 yo has a UTI. He's about to start his fourth round of antibiotics. Our ped says it is the same bacteria and she's trying all the antibiotics that are specific to it (E. coli).

We had an ultrasound done on him and his bladder, kidneys and everything measured right on - nothing abnormal. She'd like us to see a urologist in case it is related to his being intact. When the nurse called to tell me this I asked her if the urologist practice she was recommended are foreskin friendly. She said she didn't know but I could ask when I called. She said they would have special instruments to see if he has a stenosis???

I told her I didn't want to take him to a urologist that would recommend circ because we wouldn't chose that course. She said even if they did recommend it that we didn't have to take their recommendation. Um, yeah. UGH.

So, I need an intact friendly ped in the Dallas Fort Worth area that wouldn't even consider circ'ing.

I'm so frustrated because I feel like we haven't cleared up the original infection. I actually would like to talk to urologist more in depth about this bacteria and why the antibiotics haven't worked but I sure don't want to have to fight with one over retracting at the exam. More than anything I want one that will help me find a solution instead of thinking we're nuts for keeping him whole.

Any recommendations??? Even if it is just an intact friendly ped or family doc.

UTI HAS NOTHING TO DO WITH INTACT!!! Even if she were referring to the study that said that intact boys had a slightly higher chance of getting UTI (that study is extremely flawed) that is only specific to the FIRST year of life. The entire study is flawed though and has been proven incorrect.

Foreskin actually protects against UTI b/c it prevents the bacteria from entering. Here is a link about that, half way through the page there is a section about how the foreskin protects against UTI.

http://www.nocirc.org/statements/breastfeeding.php

Stenosis is a complication of circumcision so it is not the issue.

One of 2 things is happening.

1. You have a stubborn bacteria (nothing to do with his foreskin)
2. Your son doesn't really have a UTI. We have had a couple cases where the doctor's urine culture was repeated by another doc and found to be clean.

Of course you know that NO ONE should retract your son, but you should also know that he should not be cathed for any reason. Caths increase the incidence of UTI.

These doctors.....

[Cheshire]

Thanks, latinalonestar.

I'm guessing it is a nasty bacteria. He has symptoms of UTI so I'm sure he's got one. I just need a doc that can work with us to find the solution.

I didn't think it had anything to do with him being intact. In his 4.5 years he's never had an infection. He had a yeast infection when he was about 2 and we got that cleared up just fine.

I had a number of UTIs when I was little so I'm thinking it could just be the way he is made. Or, he hasn't had enough water and he's holding his pee while he is at preschool. You know, the normal things that cause UTIs (he's also learning to wipe his own bottom so he could have just transferred some bacteria to his penis in the process - he likes to retract and touch his glans a lot).

He's so funny about this. When we had to try a second antibiotic I told him the good guys brought knives to a gun fight the first time so we had to change medicine. He thinks that is the funniest analogy, so I can get him to drink more water and pee more often by telling him he's arming the good guys with guns for the gun fight instead of knives. Silly but it works!

[latinalonestar]

Originally Posted by Cheshire

Thanks, latinalonestar.
You know, the normal things that cause UTIs (he's also learning to wipe his own bottom so he could have just transferred some bacteria to his penis in the process - he likes to retract and touch his glans a lot).

I think this is the problem. He is a new wiper and likes to play with his manhood... Take over the wiping duties for a bit and make sure his hands stay away from the bum and washed so he doesn't keep re-infecting himself while he is enjoying self-discover. I suspected this at first, in fact I almost mentioned it to you. Hahaha.

[tinyblackdot]

Originally Posted by jwhispers

We've got a list and this one is on it. I don't know the source of the specific recommendation though.

Leslie McQuiston, M.D. Pediatric Urology
LocationsFTW Downtown Pediatric
1325 Pennsylvania Avenue Suite 550
Fort Worth Tx 76104 [phone]
[phone]

Also you might want to make a call to NOCIRC for a referral too. And check your PMs. If you go to him/her, or someone else, please report your experience.

Just FWIW we went to her and she wanted to schedule my, then 8 month old dd for a surgery for 3 months away (even though she said that it want safe)......so something tells me she is going to be looking to do a circ. asap.

We LOVED our urologist at children's but he moved to Europe

But in our experience the Drs from Childrens seem to be a little more upddated with the latest info than the ones at Cooks. If he is getting that many UTIs he probably has Kidney reflux, and they should do a VCUG on him, and if it comes back positive you want a Dr up on the medical facts so they dont stick you on long term antibiotics.

[latinalonestar]

Originally Posted by tinyblackdot

Just FWIW we went to her and she wanted to schedule my, then 8 month old dd for a surgery for 3 months away (even though she said that it want safe)......so something tells me she is going to be looking to do a circ. asap.

We LOVED our urologist at children's but he moved to Europe

But in our experience the Drs from Childrens seem to be a little more upddated with the latest info than the ones at Cooks. If he is getting that many UTIs he probably has Kidney reflux, and they should do a VCUG on him, and if it comes back positive you want a Dr up on the medical facts so they dont stick you on long term antibiotics.

He is 4 years old. If he had reflux they would have known by now. This is just a stubborn UTI.

[Cheshire]

My guess, too, is not reflux because this is his first UTI. It's just not clearing with the antibiotics we've tried. We're back to the first one she prescribed and I'm ready to talk to another doc that may know more or can help us find out if the E. coli he has is a more resistant strain.

[Fellow Traveler]

Originally Posted by tinyblackdot

Just FWIW we went to her and she wanted to schedule my, then 8 month old dd for a surgery for 3 months away (even though she said that it want safe)......so something tells me she is going to be looking to do a circ. asap.

We LOVED our urologist at children's but he moved to Europe

But in our experience the Drs from Childrens seem to be a little more upddated with the latest info than the ones at Cooks. If he is getting that many UTIs he probably has Kidney reflux, and they should do a VCUG on him, and if it comes back positive you want a Dr up on the medical facts so they dont stick you on long term antibiotics.

Thanks for that feedback. Like I said I didn't know the source of that information. If you have other specific recommendations, let me know so I can add them to our list. To the OP just remember to report back so that we can improve our resources.

[latinalonestar]

Originally Posted by Cheshire

My guess, too, is not reflux because this is his first UTI. It's just not clearing with the antibiotics we've tried. We're back to the first one she prescribed and I'm ready to talk to another doc that may know more or can help us find out if the E. coli he has is a more resistant strain.

Don't even worry about the reflux comment. I don't think she realized your son is 4 with a first-time UTI.

I'd place my bets on the wiping and cross contamination. Try not to worry momma you guys will resolve this!

I meant to tell you before to make sure you have him on probiotics to prevent a yeast infection.

[tinyblackdot]

Originally Posted by latinalonestar

Don't even worry about the reflux comment. I don't think she realized your son is 4 with a first-time UTI.

I'd place my bets on the wiping and cross contamination. Try not to worry momma you guys will resolve this!

I meant to tell you before to make sure you have him on probiotics to prevent a yeast infection.

didn't realize he was 4

[robertandenith]

OR you can just get a second opinion...

This was posted by another poster when we had the Foreskin Friendly doc list

Dr. Alfredo Santesteban, MD
He refuses to circumcise. I wish I had him when my first was born. He is the only one in my area that I know of that won't circumcise. But he is very pro-vax.

You can find him at one of five locations:

2755 Miller Avenue
Fort Worth, TX 76105
[phone]

1525 South Cooper Street
Arlington, TX 76010
[phone]

1604 Hospital Parkway
Bedford, TX 76022
[phone]

6421 Mccart Avenue
Fort Worth, TX 76133
[phone]

2528 Jacksboro Highway
Fort Worth, TX 76114
[phone]

[latinalonestar]

Originally Posted by robertandenith

or you can just get a second opinion...

This was posted by another poster when we had the foreskin friendly doc list

thanks enith!

[hakunangovi]

It is possible that the antibiotics were not taken for a long enough period. A couple of years ago we were treating a testicular infection (epididimitis ?) and it came right back. The second course of antibiotics lasted at least a month, and maybe 6 weeks.

[callmeluci]

Dr David Ewalt
Urology Clinics Of North Texas
8315 Walnut Hill Ln Ste 205
Dallas, TX 75231

Phone: [phone]
Fax: [phone]

This is a wonderful pediatric urologist. He performed surgery on my son when he was 7 months old. He has absolutely no issues with intact boys & will not recommend circ for infections. He can be hard to get an appointment with though.