catheterizing intact 11-months-old male

[trus]

Hello!
I suspect a UTI in my son and a nurse in his ped office (it's impossible to get an appointment with a doctor right away) told me to take him to an ER to have him catheterized. He is intact and I wouldn't like to have his skin retract during the procedure. How can I provide that the nurse or someone else will not retract it?

Maybe someone will have a suggestion on whether there is a bag difference between a regular urinary sample when a bag is placed around baby's penis and this. Obviously, the nurse was telling me that the cath-ing is more accurate since the sample will be sterile.

[beru]

I don't know about the bag catch, sorry, but I did want to address the catheterization. There was a horrible story here by a poster whose son was cathed in the ER. She specifically told the nurse not to retract, but she did anyway. And it was not a misunderstanding. She did it deliberately to make it easier for herself. It caused paraphimosis, which the doctor corrected as soon as possible. Needless to say, it was extremely painful.

I think, if you go ahead with catheterizing, you should tell the ER staff this story. Say it happened to a close friend to you and you are very paranoid about it happening. Stress strongly and repeatedly that you expect them to cath your son by feel. They do NOT need to see the urethra. If they tell you they can't do it that way, tell them you will go to another ER.

[trus]

Thank you!
In my situation I would like to take my son to an experienced ped, but I can't figure out one in my area. I am in Southern California, Los Angeles and Long Beach area. Maybe someone knows a trusttful ped I can take my son to where they would do professsional cath-ing?

[Fellow Traveler]

A few things it might be the case that a cath is more accurate. I don't know for sure but think about it this way. Her concern is (between bag and cath) is the bag might be a false positive because of contamination. If this is true a negative result should always be a negative result. A positivie result means that you might want to cath as a second opinion type thing. So do the bag and see what comes back. If he has to be cathed this can be done without retracting him. If you want a dr referal call nocirc, contact info at www.nocirc.com they'll have a list.

ETA: we also mantain a short list of peds in the resources section of the abov stickies

[redebeth]

My intact 8 month old son was catheterized at the peds, many years ago, after I had brought him in with a fever. He bled. It was awful.

He ended up having roseola infantum, nothing to do with his urinary tract. I would never do it again.

[Fyrestorm]

If you end up at the ER and they insist on cathing...and they want to retract, request a NICU nurse do the cath, they deal with intact babies all the time.

[rabbitmum]

Bags are used all the time here. I have never heard about anybody catheterising a small boy just for a UTI check.

Isn't there just as much of a risk that the catheter will drag germs into the urethra, as germs being washed out into the bag? I assume that it is germs around the urethra opening that they are worried about?

In girls that is handled by washing before getting the sample. Would they catheterise a girl to get a urine sample?

[bamamom]

I asked this years ago, and was told that all they have to do is wiggle the end of the foreskin around til they can see the opening of the urethra. No retraction necessary.

And yes, ask for a NICU nurse if they insist on a sterile cath.

[charleysmama23]

I'm a peds nurse and just wanted to say that I would avoid catheterization. Ask them to bag him (after thoroughly cleaning the area) and then if they get a positive result from that you can decide about cathing. Intact or not it's very traumatic and it is SO rarely a UTI. Hope it all works out and your little guy is feeling better soon!

[2boyzmama]

If you don't mind staying longer, ask for a bag catch first. If the bag is negative, then it's negative. If it's positive, then a sterile cath is necessary to verify that it's positive (because there's a small possibility that it could be contaminated from the skin).

Also, ask for a NICU nurse, and ask them how they intend to manipulate his foreskin without retracting it. Ask the nurse to define retraction for you.

My son was partially retracted during a VCUG after a hospitalization for a UTI at 9 weeks old, and after hearing my story, my sister's baby had a suspected UTI and she insisted on being the one to manipulate her son's foreskin during the cathing. So she held his penis, lined up the urethra without retracting, and then the nurse inserted the catheter. So that's an option as well.

[MCatLvrMom2A&X]

What are the symptoms he is having that make you suspect UTI?

[trus]

We went to a regular ped (well, a holistoc one) yesterday and put a bag aroun his penis. Then he peed and pooped at the same time, so the bag was soiled. I hope when they take a sample out of it, they will be careful not to contaminate it.

He hardly urinates during the day now (3 times-4 times only), and when he does, he cries. Also, I am concerned about his weight loss. Recently he has been losing weight (about 10 ounces in a month). He doesn't like being put on his back if it's related at all. And if I want to pull his legs to the tummy to potty train him, he won't let me (several months ago he wouldn't mind).

[MCatLvrMom2A&X]

Definatly something going on there. I hope that you are able to find the cause and get him back to where he needs to be

[Dave2GA]

The symptoms you describe sound quite serious to me. I would get him to a doc quickly. I have PMed you the name of a ped in LA.

[Fellow Traveler]

Originally Posted by Dave2GA

The symptoms you describe sound quite serious to me. I would get him to a doc quickly. I have PMed you the name of a ped in LA.

In second this.

[trus]

Originally Posted by Dave2GA

The symptoms you describe sound quite serious to me. I would get him to a doc quickly. I have PMed you the name of a ped in LA.

Thank you! THat's the doctor I took him to yesterday. The doc on vacation now so they had another person see patients. Now we'll just wait for the culture test results. I don't feel conident they'll be acurate since the bag with urine was soiled.

[MCatLvrMom2A&X]

As long as the inside of the bag was clean there is no reason to think you will get inaccurate results. I am sure your ds isnt the first to do a bit of poo on the outside of the catch bag.

Please do keep us informed when you have time. Never know when something like this might help someone else.

[tutucrazy]

It doesn't sound like UTI to me based on his symptoms. Sounds like it could be something else.

My son had painful urination and this was the reason.

[trus]

Today he didn't pee but once in the morning. Hardly eats, doesn't drink any water, nurses only a little bit. In the evening I tried to give him water to drink, he didn't want to, but I made him, and after 5 minutes he throw up. I can tell he's losing a lot of weight. We already received some results of the urine test - there is still blood in it, just like when he was 3 months, and some ketons. We are waiting for the culture results. I am thinking that's the reason he's anemic - he's been peeing out blood since he was 3 months old. He always has puffy face, I don't even want to think about a possibility of him having had UTI for 8 months (he's 11 months now)!

[MCatLvrMom2A&X]

mama. I hope that you are able to get to the bottom of all this very soon. I am glad you have an intact friendly ped. that is going to make things much les stressful on you and your ds.