Post MRI Appointment

Today we met with Dr. Sumfest again in the urology department to discuss the results of Trafton's MRI last week. He showed us the pictures from the MRI. It was actually amazing to see how clear every single organ shows up on the scan - nothing like an ultrasound. Dr. Sumfest confirmed the following: that there is, in fact, a very tiny kidney located close to the bladder (not at all where it should be located). We could see Trafton's right, appropriately enlarged, kidney in it's correct location and the left, tiny kidney was way down near the bladder. This dysplastic kidney is making small amounts of urine. This urine is then traveling through the ureter and being deposited into a cyst that is behind the bladder. This cyst is growing because none of the urine being created by the malfunctioning kidney has ever been able to escape. Dr. Sumfest proposed removing the kidney and the ureter and then aspirating the cyst. He explained that the cyst itself would be extremely difficult to remove because of it's behind the bladder location, but that by aspirating it (removing all liquid) and by removing the source of the liquid (the dysplastic kidney) it would be unlikely to reform again. He said that leaving this shell of a cyst behind should not pose any future health risks.


Dr. Sumfest said that this surgery would most likely be able to be performed laparoscopically. He explained that in laparoscopic surgery a tool is inserted into the belly button that will fill the abdomen with carbon dioxide, thereby expanding the abdomen and creating a space to work in. A camera inserted in through the belly button will show exactly where small incisions need to be made to do the procedure minimally invasively. He also explained some of the risks involved and that when they got started, they may discover that the procedure could not be completed laparoscopically. This would result in a longer operation and a much larger incision which he compared to a c-section type scar.


Upon noticing my ever-growing belly, Dr. Sumfest said that while the earliest he could get us in for the procedure would be June at best, he understood if we wanted to wait because of the arrival of our new baby. He said that this procedure would most likely last only a few hours and Trafton would be kept overnight, with a chance for early, day-of discharge as well depending on how everything goes. He said that the surgery could certainly wait another year or so if we wanted to have it done at the end of next school year. We could continue to monitor the growth of the cyst over the course of the next 16 months through ultrasounds. If the cyst got terribly large then the procedure would need to be immediate, and we could always make that choice at that time and take the days off of work. Dr. Sumfest also said that because the risks of waiting until next summer are so low, it might be beneficial because operating on a three-year-old would be slightly easier that operating on a two-year-old due to size (although he did slip in a comment about Trafton being "a big boy.") Of course. :)


So, we left the office saying that we will think about it and Dr. Sumfest just asked that we email him soon to let him know when we would like to go through with the procedure. He will be doing the operation himself, so it's nice to have a connection to him prior to it actually happening. We have a lot to consider, in addition to the financial burden of the procedure. While we have great health insurance, it will certainly not be free of charge to us.