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Does my daughter need kidney removal for an enlarged ureter?

Q: My 6-month-old daughter has an enlarged tube from the kidney to the bladder. She had infection when she was 3 months old and has been on medication till today. She had an ultrasound and an exam where they back filled her bladder and saw if it goes back up to her kidney. One doctor recommends that her kidney should be removed. I am trying to find a place, which can run a scope into her urinary tract, to see if there is any blockage in the tube. With the current prescribed medicines, her urine is cloudy. Would it be worth while to have a scope test run on her? Can the outlet tube of the kidney be repaired prior to just taking out the kidney?

A:As I see it she has VUR. For this reason itself it is not necessary to do a cystoscopy. Firstly, it is most important to clear the urinary infection, which your child seems to have since she has cloudy urine. Next she must have a scan to assess the differential kidney function. If the affected kidney has no function and the infection is persistent, then your child will need removal of the kidney. However, if the kidney has some function it must be preserved. In any case, your child will need to remain on antibiotics for a long time.

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