KARACHI: Children's urinary problem needs early treatment

KARACHI, Feb 12: Any child who suffers from urinary tract infection (UTI), which refuses to go away, may be having a problem of urine reflux. If this is not treated soon the kidneys of the child in question may be scarred, which may be the first step towards renal failure.

So said two experts from the United Kingdom - Mr Philips Ransley, a consultant urologist, and Miss H.K. Dhillon of the Hospital for Sick Children, Great Ormond Street, London - who delivered lectures at the Sindh Institute of Urology and Transplantation (SIUT) on Thursday.

They were of the opinion that such infants should be taken to the doctors as soon as possible who could order ultrasound and other investigations to determine if indeed urine reflux was the culprit.

After the talks, Mr Ransley carried out a surgical procedure on a three-and-a-half-year boy, called Zeeshan. This procedure could be viewed, through videoconferencing and closed-circuit television network, in the auditorium of the SIUT's new building.

Seeking to upgrade their skills, dozens of the SIUT's staff members witnessed the procedure performed by Mr Ransley, considered to be a pioneer in the field of paediatric urology.

Meanwhile, in their talks Mr Ransley and Miss Dhillon disclosed that ultrasound was ordered routinely for prenatal babies. This way such problems like urine reflux could actually be identified before the babies' birth.

However, most doctors and families tend to attach less importance to these findings. As a consequence, the prenatal investigations get buried somewhere in the mothers' pregnancy notes. This in turn means that investigations have to be done afresh after birth.

Reflux more often than not was due to some congenital defects. So it is imperative that these defects are identified as soon as possible, hence the need for prenatal investigations using the ultrasound technique.

Careful research in the area had suggested that the defects associated with reflux, like bladder dysfunction, should be handled first, said Mr Ransley. He strongly advised against repeated systograms because this procedure could cause infection.

Prenatal investigations had created a whole new population of patients who needed to be monitored and observed, said Miss Dhillon. Careful cataloguing was being undertaken in their case.

Mr Ransley said adequate use of juice and yogurt could be beneficial in reducing the chances of urinary tract infection. The 'father' of the European Paediatric Society, in his presentation, threw light on different paediatric strategies and treatment for prevention of urinary infection.

He suggested different infection control methods, including use of probiotics, anti-adherence factors, circumcision, prevention of constipation and antibacterial prophylaxis.

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