Urology - More Than I Ever Wanted to Know

Who would have thought there is a special doctor just for the urinary system?  I hadn't even given it a thought until we've needed one more than we ever thought we would this year.

We actually see a nurse practitioner, and she is awesome and gives us so much more time and attention than the actual doctor can.  I asked her how she found herself in urology.  I mean, is that really anyones life ambition?  As I suspected, she just kind of fell into it and now really enjoys her job.  She is good at it, I will admit that. 

So why so much focus on pee, bladders, kidneys, ureters?  The nerves that control the urinary system are further down in the spinal column than even the ones that control the legs.  Therefore, people with spina bifida almost always have urinary system issues.  Even people whose legs work fine.

Up until this summer, Melody has been doing fabulous in this area.  However, after 3 back to back urinary tract infections, we knew something was not going well.  As we suspected, she has developed vesicoureteral reflux (VUR).  This means urine is flowing back up from the bladder to the kidneys instead of out of the bladder like it is supposed to. 

Tests show that Melody has grade 2 bilateral (on both sides) VUR.  There are 5 levels, so this is very low and means there is no swelling or damage to the kidneys.  Statistically, 80% of children will outgrow this problem within 5 years.  We are praying Melody is in that percentage.

In the meantime, Melody will under go a proceedure known as Deflux. (http://www.deflux.com/)  Basically, the Urologist will build a small "dam" in the ureters where they connect to the bladder.  This dam will allow urine to flow over and into the bladder from the kidneys, but prevent urine from refluxing back up into the kidneys. It is a fairly simple proceedure which will be done as soon as we can get insurance approval and everything lined up.

Why are we choosing the Deflux if Melody will likely outgrow the VUR?  If we don't, Melody will have to be on a low-dose of antibiotics daily for possibly the next 5 years, or until she outgrows the VUR.  There is a greater chance of repeat UTI's while on the antibiotics than there is if she has the Deflux done.  Also, there is the risk of developing resistance to the antibiotics.  Though it is likely Melody will outgrow the VUR, we need to be diligent to prevent kidney damage in the meantime.  Also, there is a high probability that we can avoid several years of not so fun tests if we go this route.  Plus, Melody just hates the antibiotic, so it is a daily battle to get them in her.

We are hopeful that this will solve the recurrent UTI issues as Melody has had a rough few months not feeling so well.  So pray with us for resolution of this issue and for downward flowing urine!