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Dr. Tharun
Dr. Tharun, Urology Resident
Category: Urology
Satisfied Customers: 3682
Experience:  MBBS, DNB surgery and presently working as Urology resident towards the degree of Urologist.
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Im a FP. 5 year old male. Dysuria for a day. Increased

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Im a FP.
5 year old male. Dysuria for a day. Increased urinary frequency noted at school by nurse.
Hx of Hydronephrosis.
No fever or back pain.
Unequivocal UA but not " totally clean".
Treat and wait for culture, or not treat and wait for culture.
Is either ok?

It is a male child with history of hydronephrosis and with symptoms of UTI , you should put him on antibiotics straight away. If culture shows different sensitive antibiotic from what you have started , you can shift to that antibiotic according to the report.

The biggest worry in such cases is ascending infection into the kidney and causing pyelo-nephritis which eventually will result in renal scarring. So prevent it before it happens.

If the hydronephrosis was due to reflux problem , prophylactic antibiotics should be considered. Although prophylactic therapy after 5 years is still debatable in a male child.

Right now the child should be on antibiotics with out waiting.

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