This procedure disintegrates the stone without the need for surgical incisions. Less commonly, the stones need to be treated with endoscopic stone removal or open surgery. These UTI's may go under-diagnosed as some children may be given other diagnoses for fever without proper examination of the urine. If a true UTI exists then renal and bladder ultrasound as well as a VCUG should be performed to rule out any renal or bladder anomalies. Thirty to forty percent of children with a UTI will have some type of urologic congenital anomaly.
Vesicoureteral reflux is one of the more common anomalies.
This is the improper retrograde passage of urine of the bladder up towards the kidney. Most children develop grade 1-2 reflux and fortunately this will resolve over time in the great majority of cases. The goals of treatment in reflux are to prevent infected urine from reaching the kidney which can cause scarring, hypertension, proteinuria and even end stage renal disease. Therefore many of these children are placed on low-dose daily antibiotics. If reflux is of high grade or associated with a concomitant condition that will make its resolution unlikely then surgical repair of reflux is an extremely effective and appropriate option.