Mild pyelectasis and postnatal UTI issues?

[Calleiah]

So we dont *know* we're having a boy, but my intuition has told me boy since conception practically! We found out at 19 weeks during our anatomy scan that baby's kidneys are dilated (5mm) and followed up this week with another scan, where again we see the kidneys dilated (7-8mm). Just the fact we have this issue point at boy since the ratio of boys to girls with this condition is considerably higher. We'll be going to see a Peri, but just looking ahead I am preparing for the possible postnatal possibilities. Frequently if the issue persists after birth, they want to do a postnatal sono, VCUG, and prophylactic antibiotics to prevent UTIs. The first of those options I have no problems with, the VCUG requires catheterization and pushing contrast up in there to see it all by real-time xray. I've read the horror stories about sweet uncirced baby boys and catheters. I may have to kill someone over that kind of issue, know what I mean? Im not thrilled with high dose antibiotics long term either. My other big concern is that Im going to end up with some idiotic doctor who insists that I *must* circ my son or have huge issues. I know it's not true, but we know how much of the medical community can be about not circing. Oh the misinformation! So I guess what Im asking is.... Has anyone here been through this? How did it turn out (postnatally). Complications, experiences, etc?

Thanks ladies!

[Night_Nurse]

I have no experience with it personally. I just wanted to say your child is lucky because before he's even born, he has a parent who knows more about intactness and the harm circ can cause than many US doctors know. I'm sure more parents will chime in here in a bit and share their experience.
Maybe it's best to start looking now for a foreskin friendly doctor/urologist in your area. Maybe you can even ask for a local recommendation in "finding your tribe".

[Calleiah]

Ohh! Thats a great idea! My OB is very interventionist, Im sure the Peri she's sending me to is as well so maybe Ill get the jump on them and have the Pediatric Nephrologist lined up already!
Thanks for the idea! I want to be as prepared as possible so my kiddo doesnt have to go through more than is necessary.

[2boyzmama]

HI there!

My middle son was hospitalized with a UTI at 9 weeks old, and they did all the follow-up testing that you are describing. The renal scan (ultrasound) was no big deal at all.

The VCUG was, because like you fear, we got a tech that didn't know what she was doing and tried to retract him. After that experience, I found online somewhere (maybe even at AAP?) instructions on how to catheterize an intact male, and I carried those around in the diaper bag. He had to have several more caths in the following months, and each time I *made* the tech or nurse read the information sheet and describe to me exactly how they were going to do it without retracting him. I had one or two people grumble at me, but also had a few who said "I'm so glad to see a parent care like you do."

We did do daily abx until it was proven that he had no urinary reflux. It's not an ideal answer, but neither is permanent damage to kidneys, which is a very real possibility if there is urinary reflux.

My sister-in-law had heard of my experience with the VCUG, and when her son needed cathed, she insisted that SHE would be the one to touch his foreskin, not the nurse or tech, and that way she was sure that no one retracted him.

Basically, to cath an intact penis they just need to move the foreskin opening around a bit until the opening of the meatus is visible. No retracting necessary. No cleaning under the foreskin necessary.

[PuppyFluffer]

I applaud your knowledge and your instincts to protect your baby! I think you are RIGHT ON!
I am not familiar with the issues you are possibly dealing with but I do know that NICU nurses tend to be more skilled at cathing an intact boy. It might be beneficial to insist on a NICU nurse if they will honor that request.

I would have huge concerns about antibiotics.

[So-Called]

I don't have any experience with caths or other testing, but my DS had mild pyelectasis in utero and has had ZERO postnatal problems. No UTIs, no foreskin issues, no nothing. I hope this is the case for your baby, boy or girl!

[Calleiah]

Thanks guys, Im thrilled to get some feedback!
2boyzmama- I think it was actually your story that I was remembering. Didn't you post about that a while back? It really stayed with me so when I read about the VCUG as a possible test I started to try to get my ducks in a row so I dont have to kill some poor nurse. Ill go find those instructions so I dont have to fumble around looking later. I swear, I've just about downloaded a book to carry with me through the last trimester and birth! LOL Instead of arguing with people, Im just going to start handing out information and tell them to re-educate on their own time, we're doing it my way or else.
Obviously we're not 100% sure about this being a boy, but I've had overwhelming conviction practically since conception that this was a boy. I dont know how else to explain it.
PuppyFluffer- Ill keep that in mind about the NICU nurses. I know when I take my girls for blood draws that I always ask for a NICU nurse or a L&D nurse because they tend to be a better shot when you have teeny tiny veins.
So-Called- Thats my most sincere hope! It's pretty minor right now and hopefully by the time we get to the Peri, it will be resolved all together!

Thanks for understanding my concerns ladies. I read all too often the misinformation given out by doctors, whether it's retracting or circing, etc. I really dont want to have to throttle some unsuspecting doctor simply because he's uneducated but *thinks* he is.

[Calleiah]

Just wanted to update on what we've found out! Went to the Peri, he was just as panicky as I figured he'd be. He set us up an appointment with a pediatric Nephrologist so I was kind of preparing for more "ZOMG, we must run all these tests after birth" kind of attitude. I was SO pleasantly surprised! This doc basically said if we were in Europe, they wouldnt have even flagged me at all, that this could very well be just a variation of normal for this baby. He said he saw no reason why we'd need more scans but if we wanted to for peace of mind, to bring the baby in at 6 weeks for a quick sono scan of his kidneys. He said he doesnt believe in the prophylactic use of antibiotics because after they've had the first UTI, the antibiotics basically dont reduce the chances of another UTI. He was terrific and very 'science based medicine' minded. I was THRILLED.
So we're 2 weeks from term, and of course my OB has decided she wants one more sono "just in case". Now I have to find a tactful way of telling her no.
Just wanted to let everyone know how things are going.

[PuppyFluffer]

What a fabulous update! Did you talk to the nephrologist about his thoughts on intact and foreskin care? If so, what did he say? It sounds wonderful! If he's got his intact care straight, it sounds like he's be a great doctor to add to the list of foreskin friendly doctors that NOCIRC keeps.

[Calleiah]

Honestly, he did not bring up the circ issue and I didnt either! If we go in for the 6 week sono (DH wants to for peace of mind), Im sure it will come up. Good news is this doc isnt going to do the VCUG without really good reason, which thrills me to death. Ill be back to let everyone know what happens!