Q: My son had repeated UTI at the age of 3 and was diagnosed with reflux. He was kept under observation under antibiotic cover, with regular urine tests till this year (age 6y). We had a DMSA scan done recently which indicated bilateral renal cortical scarring. Nuclear scan showed that renal function is OK. MCU showed Grade IV reflux. He was operated and surgical correction of bilateral re-implantation of ureters done this May. He was maintained on chemoprophylaxis. Antibiotics were stopped there after and repeat urine test showed pus cells 18-20/hpf with positive culture. I would like to know how long will antibiotics be needed after operation? What is the normal recovery after such an operation for the bladder to remain infection free? We have been advised to repeat DMSA and Nuclear scan after one year of operation? Is it correct?

A:Your child has received what most people across the world would accept as standard treatment. Antibiotics are usually given for 6 to 12 weeks post-operation. Sometimes children continue to get urinary infections afterwards but just the presence of pus cells in the urine must not be inferred as urinary infection. It is very important to collect the urine sample properly and have it evaluated at a good lab as this test is prone to a lot of errors. I would not be very concerned if there was no fever associated at the time of this sampling. It is good to have a post-operative evaluation. I would advise an ultrasound at 6 months and 1 year post-operation. If there are any concerns then the nuclear scans may be repeated.