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Ped urologist for bladder reflux VUR?
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amother
OP


 

Post Fri, Oct 22 2021, 10:37 am
Hi. We were referred to dr stock at Sinai because baby was born there. Wondering what the experience was for surgery? He took very little time with us the first app and wasn’t very talkative / warm. I’m not sure how comfortable I feel going thru something major with him. Any other recs or personal stories with stock?
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amother
Magenta


 

Post Fri, Oct 22 2021, 1:00 pm
Hi,
I used him for my son too!
and go for yearly check ups now.
hes an amazing doctor you can rely on. knows his work very well!!
no hes not talkative and not the type to spend time with you. but he knows what hes doing and saying...... you can be very calm with him!

How old is your baby?
hatzlacha rabba
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amother
OP


 

Post Fri, Oct 22 2021, 1:01 pm
Almost 4 months. Did he do surgery?
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amother
Magenta


 

Post Fri, Oct 22 2021, 1:08 pm
I had surgery done 10 days after he was born.
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amother
Pear


 

Post Tue, Sep 06 2022, 11:39 am
Bumping this up. Op, if you dont mind sharing what ended up happening? My unborn was just diagnosed with this. Being referred to Dr. Stock.
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amother
OP


 

Post Tue, Sep 06 2022, 11:42 am
We switched from stock to Schlussel. Still being monitored (14 months old now). Last US was clear and will be doing a voiding x ray at 18 months to determine if surgery is needed. I’ve calmed down a lot since this post. Schlussel is nice and kept telling me to calm down. Stock is nice too but a bit more reserved and less reassuring. I’m really hoping his next test is clear. Schlussel said that he has seen grade 5 and 4 go away with growth. We give 2 ml antibiotics daily in the afternoon. In the am I give a powdered probiotic so he has a good buffer for any unwanted affects. My advice is to get a ultrasound of the bladder post birth (pedi can order it). Then go with the CD and report to whoever you see. Do not leave any radiological appt without a disk with images. Keep them all and bring to every appt. You may want to switch drs and it’s a headache.
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amother
Pear


 

Post Tue, Sep 06 2022, 12:01 pm
amother OP wrote:
We switched from stock to Schlussel. Still being monitored (14 months old now). Last US was clear and will be doing a voiding x ray at 18 months to determine if surgery is needed. I’ve calmed down a lot since this post. Schlussel is nice and kept telling me to calm down. Stock is nice too but a bit more reserved and less reassuring. I’m really hoping his next test is clear. Schlussel said that he has seen grade 5 and 4 go away with growth. We give 2 ml antibiotics daily in the afternoon. In the am I give a powdered probiotic so he has a good buffer for any unwanted affects. My advice is to get a ultrasound of the bladder post birth (pedi can order it). Then go with the CD and report to whoever you see. Do not leave any radiological appt without a disk with images. Keep them all and bring to every appt. You may want to switch drs and it’s a headache.

That's reassuring to hear. Is your baby a boy or girl? Any issue with bris on time?
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amother
OP


 

Post Tue, Sep 06 2022, 12:13 pm
Boy. On time despite being born 37 w. No reason to delay. Trapped bacteria will raise the risk of infection.
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amother
Pear


 

Post Tue, Sep 06 2022, 12:25 pm
amother OP wrote:
Boy. On time despite being born 37 w. No reason to delay. Trapped bacteria will raise the risk of infection.

Thanks so much for answering. I'm still so new to this and worried sick. I have no idea what awaits. My ob/gyn keeps on telling me it might still resolve before birth but at this point I'm not so sure anymore.
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amother
OP


 

Post Tue, Sep 06 2022, 12:27 pm
Honestly what they saw on US from 20 weeks on differed greatly from what they saw at his first ultrasound. It can resolve at any point with growth. But we found he had reflux in both kidneys vs a ‘small’ left kidney. I’m not sure if we can connect vis this platform but I’m happy to talk to you.
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amother
Pear


 

Post Tue, Sep 06 2022, 12:33 pm
amother OP wrote:
Honestly what they saw on US from 20 weeks on differed greatly from what they saw at his first ultrasound. It can resolve at any point with growth. But we found he had reflux in both kidneys vs a ‘small’ left kidney. I’m not sure if we can connect vis this platform but I’m happy to talk to you.

That's not very reassuring to hear Sad . My babies is in the right kidney. It's not too big but not small either.
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amother
OP


 

Post Tue, Sep 06 2022, 1:58 pm
I mean I used one of the best high risk groups in the country and it’s hard for them to get imaging in utero of these things. They could tell the size was lagging and that’s about it. They got his birth weight correct to the decimal tho. I think all you can do is prepare for the next steps after birth and make sure u can take good care of yourself post partum. I cried a lot at his first voiding X-ray. After that I learned what I could and we are still powering through. It’s relatively common.


amother Pear wrote:
That's not very reassuring to hear Sad . My babies is in the right kidney. It's not too big but not small either.
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amother
Pear


 

Post Tue, Sep 06 2022, 3:19 pm
amother OP wrote:
I mean I used one of the best high risk groups in the country and it’s hard for them to get imaging in utero of these things. They could tell the size was lagging and that’s about it. They got his birth weight correct to the decimal tho. I think all you can do is prepare for the next steps after birth and make sure u can take good care of yourself post partum. I cried a lot at his first voiding X-ray. After that I learned what I could and we are still powering through. It’s relatively common.



Will my baby need a voiding x-ray shortly after birth? From what I understood all he'll need is a sonogram of the kidneys.
I was told that the sonogram might not be accurate than irl, but they told me that irl it might not be as bad, they didn't tell me it can be worse.
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amother
OP


 

Post Tue, Sep 06 2022, 3:28 pm
We did the voiding cystogram at 4 months. If you want more information it’s best to talk to a urologist not a obgyn/mfm. It’s common but not that common that I would trust the obgyn on something like if they say it cant be something worse or different. The mfm I worked with told me 95% chance it’s nothing to worry about. She was very wrong. They can’t know or see everything at that stage. How far along are you? I also had to be induced early because there was little to no fluid left around 37w. Bh I was being watched bc of the kidney very carefully and my baby was born a great size, didn’t need any nicu time and went home a day and a half later


.
amother Pear wrote:
Will my baby need a voiding x-ray shortly after birth? From what I understood all he'll need is a sonogram of the kidneys.
I was told that the sonogram might not be accurate than irl, but they told me that irl it might not be as bad, they didn't tell me it can be worse.
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bnm




 
 
    
 

Post Tue, Sep 06 2022, 4:44 pm
Request a sono in the hospital, tell them there was concerns. My ob had done a sono every 4 weeks and monitored saying it seems to be getting better but to do the sono post birth to confirm. Child was put on prophalactic antibiotics till they can see a urologist at 4-5 weeks who redidd the sono and ordered a VCUG. VCUG done at 6 weeks confirmed urinary reflux, grade 3. Child was on antibiotics and saw the urologist every few weeks and as he got older it turned into months. Any time he had unexplained fever we did a urine cultrue.
At 18 months we redid the vcug and his grade 3 reflux had disappeared. We follow up with the urologist every 18-24 months now just to keep an eye on the hydrenephrosis. I used/use someone in Brooklyn but did go for a second opinion to Dr. Layne Palmer but I don't think he is in NYC anymore.
The next child also showed hydrenphrosis prebirth but didn't have any post.
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amother
Pear


 

Post Tue, Sep 06 2022, 7:01 pm
amother OP wrote:
We did the voiding cystogram at 4 months. If you want more information it’s best to talk to a urologist not a obgyn/mfm. It’s common but not that common that I would trust the obgyn on something like if they say it cant be something worse or different. The mfm I worked with told me 95% chance it’s nothing to worry about. She was very wrong. They can’t know or see everything at that stage. How far along are you? I also had to be induced early because there was little to no fluid left around 37w. Bh I was being watched bc of the kidney very carefully and my baby was born a great size, didn’t need any nicu time and went home a day and a half later


.

I got all this info from Refuah who's referring me to Dr. Stock. I'm 30 weeks. I have to go for monitoring every 4 weeks now.
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amother
Pear


 

Post Tue, Sep 06 2022, 7:03 pm
bnm wrote:
Request a sono in the hospital, tell them there was concerns. My ob had done a sono every 4 weeks and monitored saying it seems to be getting better but to do the sono post birth to confirm. Child was put on prophalactic antibiotics till they can see a urologist at 4-5 weeks who redidd the sono and ordered a VCUG. VCUG done at 6 weeks confirmed urinary reflux, grade 3. Child was on antibiotics and saw the urologist every few weeks and as he got older it turned into months. Any time he had unexplained fever we did a urine cultrue.
At 18 months we redid the vcug and his grade 3 reflux had disappeared. We follow up with the urologist every 18-24 months now just to keep an eye on the hydrenephrosis. I used/use someone in Brooklyn but did go for a second opinion to Dr. Layne Palmer but I don't think he is in NYC anymore.
The next child also showed hydrenphrosis prebirth but didn't have any post.

One of the things I'm most scared about is the vcug. I hear its a pretty difficult test on the kid. I had a niece now married who I now think had this. I don't want to ask my sibling because so far we decided not to tell anybody. That might change after birth though.
You're saying you have to monitor every 18-24 months, isn't it something that eventually goes away on its own or with surgery? Refuah told me either or. Buyt once it's gone it's gone.
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amother
OP


 

Post Tue, Sep 06 2022, 7:17 pm
I was every 4 weeks til 32 then 34 and 36 and didn’t make it to my 37w appt. I saw my ob on Tuesday. I couldn’t coordinate my mfm appt the same day as my ob so that was Thursday. By then I had one pocket of fluid left and it was low. This is a direct result of a issue with the kidneys not functioning properly. They told me I really had no choice but to be induced. I went to be induced that night after steroid shots. Bh bh the hospital ped said she never ever saw a baby 36 weeks old as healthy as mine. Baby was born just before shkia Friday night. The induction was annoying and long because I was so early it took forever to dialate. The actual delivery took less than 10 mins tho. He was over 7 lbs. The hospital ped spoke to dr stock while we were in the hospital and gave us his instructions. I really just needed to know what to do when at that stage and if the bris could be on time. My beautiful baby is currently sticking his fingers in my mouth and pinching my cheeks as I nurse him before bed. He is a darling beautiful miracle child. I am sure he will beat this. And even if he does need surgery there is nothing we could’ve done to prevent this.
amother Pear wrote:
I got all this info from Refuah who's referring me to Dr. Stock. I'm 30 weeks. I have to go for monitoring every 4 weeks now.
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amother
Pear


 

Post Tue, Sep 06 2022, 7:30 pm
amother OP wrote:
I was every 4 weeks til 32 then 34 and 36 and didn’t make it to my 37w appt. I saw my ob on Tuesday. I couldn’t coordinate my mfm appt the same day as my ob so that was Thursday. By then I had one pocket of fluid left and it was low. This is a direct result of a issue with the kidneys not functioning properly. They told me I really had no choice but to be induced. I went to be induced that night after steroid shots. Bh bh the hospital ped said she never ever saw a baby 36 weeks old as healthy as mine. Baby was born just before shkia Friday night. The induction was annoying and long because I was so early it took forever to dialate. The actual delivery took less than 10 mins tho. He was over 7 lbs. The hospital ped spoke to dr stock while we were in the hospital and gave us his instructions. I really just needed to know what to do when at that stage and if the bris could be on time. My beautiful baby is currently sticking his fingers in my mouth and pinching my cheeks as I nurse him before bed. He is a darling beautiful miracle child. I am sure he will beat this. And even if he does need surgery there is nothing we could’ve done to prevent this.

It's so interesting what you're saying about the fluid, because when they measure the amniotic fluid they have a range. Mine was on the higher end. Like middle high rather than middle range or middle low. I wonder if there's any relation to the kidney issue.
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amother
OP


 

Post Tue, Sep 06 2022, 8:18 pm
I think it can go either way. Polyhydraminos has a few dif reasons as far as I know . I think diabetes is one. Oligohydraminos is almost always correlated to kidney dysfunction in the fetus.

amother Pear wrote:
It's so interesting what you're saying about the fluid, because when they measure the amniotic fluid they have a range. Mine was on the higher end. Like middle high rather than middle range or middle low. I wonder if there's any relation to the kidney issue.
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