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Wednesday, April 23, 2014
Urinary and Genital Disorders (Children)
Skin Tag Sign of Kidney Problems?
I just had a baby four weeks ago. At birth she had a tiny "skin tag" near her ear that was as thin as a thread. By the second day in the hospital it turned black and fell off. The nurse practitioner that we see suggested a renal ultrasound due to the skin tag. The ultrasound shows her kidney has minimal dilatation but size of kidneys are accurate. Now practitioner wants a VCUG performed and I am scared and would hate to put a four week old through this. My baby urinates regularly and shows no signs of pain or discomfort. Is all of this necessary at her age?
I can understand your concern regarding the VCUG. Unfortunately, there is no consensus. The dilation of the renal pelvis could be a sign of urinary reflux, which would increase the risk of developing a kidney infection. However, the risk of having reflux is approximately 15%. I have not been obtaining a VCUG in this circumstance, but would do it if the hydronephrosis grade is 2 out of 4 or higher.
Jack S Elder, MD, FACS, FAAP
Clinical Professor of Urology
School of Medicine
Case Western Reserve University