Our daughter birth on December 3,2003 (now 6 months) has been diagnosed with VUR Grade IV bilateral. It was detected when she was 3 months by VCUG. Prior to that she had UTI when she was 1 month old. She was born weighted 3.1 kgs, 49 cm, and now she is 6.8 kgs, 66 cm. She phisycally had a considerably good development. Now she is under treatment with profilaxys antibiotics (bactrim), and regular urine check (cultur). The problem has been escalated to urolog surgeon, and he recommended to do the stitoscopy simultaneously with reimplantation ureter when her urine is sterile. Since March (after VCUG) her urine has never been sterile, and the bacteri is Klebsielle Pneumoniae (always the same bacteri). After 3 times antibiotic treatment (with Urineg, Ammoxilyn Acid, and again Urineg) her urine is still not sterile. She wasn't always having fever, but sometimes she had mild diarrhoea. Our pediatric informed that the surgery could be done even with the unsterile urine condition with antibiotic protection pre-surgery, if the urolog surgeon agree with the condition. We are now in the stage of consult this matter to the urolog surgeon. Our question are :
1. Does surgery the best solution for her condition )VUR Grade IV bilateral, repeated UTI), considering her age.
2. Is there still any possibility her VUR will disappear itself along with her growth.
3. How is the risk of waiting for the possibility compare to the risk of surgery in her early age?
4. Is this a common case, especially for infant? Is there any medical center specializing on this case (preferably around Asia)
THANK YOU.