urodynamics / septra / cathing / neurogenic bladder questions

[Kate]

My baby had his cord un-tethered at 4 months, and has been on low-dose Septra ever since. I started out cathing him 4 times a day, then 3, now I do 3 usually, but sometimes do 2. He had 1 UTI (they think - they're not sure? is there such a thing as a UTI with 0-5 in the culture??), and has a urodynamics study at the end of July.

Can anybody tell me what to expcet for that urodynamics study?

Our hospital is Children's Hospital at Dartmouth.

Also, the Septra is a good thing, right? I never questioned it until I read a few threads here (he-heh).

If he DOES have a neurogenic bladder, what does that mean? Practically speaking?

Sorry if this is too many questions or if they have already been answered here. I really, really appreciate the help!

[n3rdchik]

A neurogenic bladder is just the term for a bladder that doesn't work right due to nerve damage. If you have to cath, it is neurogenic.

The urodynamics study should be the same series of tests they did before the surgery for a baseline:
a VCUG (http://health.med.umich.edu/healthcontent.cfm?xyzpdqabc=0&id=6&action=detail&AEProductID=HW_Knowledgebase&AEArticleID=hw210845)
a cystometrogram (http://health.med.umich.edu/healthcontent.cfm?xyzpdqabc=0&id=6&action=detail&AEProductID=HW_Knowledgebase&AEArticleID=ug3121)
and a kidney ultrasound

All three are pretty quick and didn't seem to upset Sagan much. The other questions - I am clueless on and will be seeing what the vetrans say ;-)

[Summer25]

Actually a urodynamics is when they fill the bladder up and are able to check the pressure of the bladder. So, it isn't all three tests. It is just one.

[Kate]

Will I be able to stay with him during the urodynamics? How will they fill his bladder up? How long does it take? It's not sedated, right? (I asked on this one, and got 2 different answers - he will be 7 months old). They did do a kidney U/S about a month ago.

[Mustang Sal]

Hi Kate,

Welcome to the forum :)

I can only speak from an adult perspective (but assume the process is the same for children), but the test will probably go a little something like this. Bladder scan to check how much is in there, insertion of tiny sensors and catheters into the urethra and rectum, gradual filling of saline into the bladder via the catheter while they watch what the computer does (the sensors will alert them when the muscles in the bladder start to contract), and will also obviously watch for any leakage, and note when this occurs. They may repeat this process. The saline is drained, then there may be another ultrasound (some hospitals also do the VCUG at the same time, which n3rdchik mentioned below, so you might want to check this). And that's pretty much it! Like I said, i'm not too sure about how it would work with young children and babies, because in my test they asked me to tell them when I felt something, which young children obviously can't do. It's a pretty good test when it comes to diagnosing neurogenic bladder, and a lot of other bladder problems besides. I got my results straight afterwards too, as a member of my doctor's team was present - fingers crossed you don't have to wait too long either.

I also had a renal tract ultrasound, but this was done a few weeks after, once my consultant had evaluated my urodynamics result.

Hope it all goes well!

[Kari]

Will I be able to stay with him during the urodynamics? How will they fill his bladder up? How long does it take? It's not sedated, right? (I asked on this one, and got 2 different answers - he will be 7 months old). They did do a kidney U/S about a month ago.

Zach has them every 6 months or so. He is not sedated, and I sit with him and distract him. When he was little, I often gave him a bottle, and as he has gotten older, I hold toys up above him and play with him. In my opinion, the littler they are, the easier the test is to complete. It doesn't take long to complete - less than half an hour. It depends on how much the bladder holds. A bladder that holds only 30ml fills up a lot faster than a bladder that holds 100ml. They're checking how much it holds, watching the pressures, and watching for leakage.

[Dodger67]

For a baby, half an hour is probably a good ballpark estimate for the test itself but plan on being there for an hour in total.
Sedation is not used as that affects the muscle activity which would defeat the entire purpose of the examination.
The result of the test is a set of volume/pressure/time graphs that enable diagnosis of the presence/intensity of muscle activity of the bladder.
A high pressure bladder is obviously treated quite differently from a low pressure one.

Wikipedia has fair (not brilliant yet) articles: http://en.wikipedia.org/wiki/Urodynamic_testing
http://en.wikipedia.org/wiki/Cystometry

[angel]

I took septra for YEARS when i was a child as a maintnance drug to keep infection low since i have a kidney reflux. At age 9 they took me off the septra and put me on macrodantin which i took for 20 years. At 29 they put me back on septra. It isn't bad and if i remember correctly the liquid version was pink and it didn't taste that bad either :)

Angel