Jay's meeting with the pediatric urology specialist & official diagnosis

So I'm sure everyone is wondering - how'd Jay's appointment with the pediatric urology specialist go today?

Seemed like it went well and was very informative.

They weighed him to start and checked his vitals - his blood pressure was good and his weight is up to 13lbs, 2.8oz so he's gained some since his regular check-up he had last week.

The specialist went over the scans from the testing they did back in April and explained more of what it showed and what it meant.

Jay's official diagnosis now is that he has a UVJ ureter obstruction. Below is the diagram that the specialist drew me for to sort of explain what's going on:

On Jay's right side (the left side of the image), his kidney and ureter look perfectly normal, going into the bladder as it should. On his left side though (the right side of the image) the part of the ureter tube that feeds into the bladder (the UVJ) is tapered off so much that nothing can get out (or in) and a bit deformed.

I asked what causes this and he said what happens in these cases generally is that at about 2-3 weeks after conception is when the bud of the ureter tube is formed on the bladder and branches out to form the tube up to the kidney. Basically, his left one was just a dud and didn't form properly.

He said that while it still is possible that it could grow and open up on its own as he grows, he said he doesn't want to get our hopes up and said that realistically he'll probably need the surgery to fix it. He said it's basically a problem that he has "bad plumbing" and that he can fix it, as he has plenty of times before and says the surgery is almost always successful (of course they can't say it's 100%, as there's always that slim chance something could go wrong, but he seemed very confident that it was just a simple, minor procedure and nothing to get worried about). He said what they'll do is they'll continue monitoring it via renal ultrasound every 3-4 months and when his bladder is big enough (usually between 1 and 2 years of age), he'll do the surgery, pulling out the ureter tube from the bladder, cutting off the bad part and then reinsert/attach it to the bladder.

He said other than the UVJ obstruction, everything else about Jay looks 100% - he said even the kidney that's blocked looks to be completely healthy, and while you only need 1 kidney to leave, just in case something happens down the road to the one, he'd like to have the other one fully functioning as well so we don't have to worry about it then.

He said another option they could do if it became necessary (ie: something happened to his right kidney and we needed the other to function asap), they could do a temporary ureterostomy where they make a hole in him and the tube is sticking out onto his belly and that everytime he pees it would drain out onto his belly... yeah, that just sounds messy, and gross and more of a hassle than we need, so we're not planning on doing that.

He also put him on another antibiotic, taking him off the amoxicillian, so that he doesn't get any long-term effects of the amoxicillian (I guess it's been known to give stomach problems and can cause diarrhea) and this one is more to prevent and treat any possible UTI infection (basically, it's more specific than the amoxicillian).

So... I'm doing alright. Not thrilled at the fact that he'll probably have to have the surgery come 2013, but it is a ways off too so it's not like I have to think about it. He'll probably have the scar from where they go in on the left side to get to it though for awhile... the doc's confidence though at how well the surgery goes seemed to put me more at ease, so I guess we'll just deal with it when the time comes.

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