Trafton's Visit to the Urologist

Today Trafton went to see a urologist at Geisinger Medical Center in Danville. When he was born with one kidney, doctors did an ultrasound to confirm that there was only one kidney. They found that one kidney was present.

Five days later Trafton had another ultrasound done where they injected him with dye through a catheter to see if kidney/urine reflux was present. There was not and this was good news. We saw a nephrologist (kidney specialist) who told us that we would need to come back one time each year to monitor the function of the one kidney that Trafton did have.

Last summer when Trafton was one year old, we saw the nephrologist again. This ultrasound showed that Trafton's one kidney was enlarged (again, good news) to the size of a seven-year-old's kidney. This was expected due to the need for overcompensation for the missing kidney. Everything looked good except the nephrologist noticed a small mass located on Trafton's bladder. When she looked back at the ultrasound from Trafton's birth, she saw that the mass was present but incorrectly labeled as the rectum. She called it a mesonephric duct cyst and said that it needed to be checked out by a urologist.

Which brings us to today and our trip to see the urologist, Dr. Sumfest. We first got another ultrasound done and Trafton was great! He was so cooperative throughout the procedure; it was wonderful! Then we saw Dr. Sumfest. He said that this mesonephric duct cyst was enlarged quite a bit from the ultrasound six months ago. His theory is that this mass is not a cyst at all, but actually a very, very small second kidney that is not functioning properly. While I was pregnant, one of the high risk doctors that we saw mentioned that a kidney remnant may be found after Trafton was born. None was ever found on subsequent ultrasounds. Because ultrasounds are not very detailed, Dr. Sumfest said that he would like an MRI done to confirm that this cyst is, in fact, a second kidney. During the MRI, Trafton would need what the doctor called heavy sedation so that he would be able to lie very still for up to 45 minutes. They would use propophol and Trafton would need to be able to breathe on his own. Dr. Sumfest assured us that he would be very closely monitored by the pediatric radiology department and that they are excellent. He said that many departments needed to approve this MRI, so although he put the order in for the MRI immediately, it may take up to one month for someone to call us and schedule it.

If, after this MRI, it can be confirmed that this cyst is a small kidney, and that it is being enlarged because small amounts of urine (he said maybe like one teaspoon per month) are being trapped inside of there, then the removal of this kidney would be necessary. I asked him how invasive of a procedure this would be and he stated that it was "extremely rare" and "pretty invasive because we are taking an organ out of a small child." Yikes. He said also that he is not concerned about cancer in any way at this time, because he does not believe it is a cyst. If the MRI confirms everything that he is thinking, the removal of this kidney would be necessary because as it grows larger, there is an increased chance of it causing all sorts of "serious infections."

So, at this point, we are waiting for the next month to be contacted by someone from the urology department giving us the approval to schedule the MRI with pediatric radiology.

Trafton, throughout the appointments this afternoon, was pretty well-behaved. He walked the halls, climbed on benches, charmed the nurses, played with a pinwheel one of the nurses gave him, drank a smoothie, ate half an apple, played the animal sounds game on our iPad, ate an entire bowlful of graham-cracker bears, looked inside of trashcans (a new and disgusting habit!), and only had one temper tantrum on the long walk out of the hospital when we were finished. Can't blame him - he missed his nap through all this :) Needless to say, we are all exhausted!