Q: My three years old son has been complaining of pain in his penis for the last one month. The doctor told us that it is because of fore skin contraction and gave some pain killers, which didn't help at all. Then, we took our son to another doctor, who told us that this is because of urine infection and asked us to get our son's urine test done. The test reported high pus cells in my son’s urine and so, the doctor prescribed ZEFU medicine. Though this treated the urine infection and there is no pain now, the doctor is asking us to get Ultra Sound and MUR test done to rule out any chances of kidney problem. Are these two tests required?

A:Urinary tract infections in boys are most common before the first birthday. In young girls, UTIs are most common around age 3, overlapping with the toilet training period. Cystitis in children can be promoted by abnormalities in the urinary tract. Therefore, children with cystitis, especially those under age 5, deserve special follow-up to prevent later kidney damage. Whether the child is circumcised and presence or absence of voiding dysfunctions and constipation are important considerations in history. A thorough local and systemic examination is necessary to exclude any spinal problem. It may be necessary to have some imaging investigations to exclude developmental defects as precipitating causes. Ultrasound of the kidney and bladder followed by micturating cystourethrogram if necessary, are such investigations to eliminate subsequent infections and potential damage to the young kidneys.