3-Year-Old Feels Like a “Superhero” After Urinary Tract Reconstruction at Jersey Shore University Medical Center

K. Hovnanian Children’s Hospital team successfully addresses hydroureteronephrosis in a duplex collecting system

Life with a newborn is rarely easy, but for Deanna Sorbera, the days after her daughter Audrina’s arrival on Christmas Eve 2020 were especially stressful. Born with a condition called hydroureteronephrosis in a duplex collecting system—when a kidney has two tubes called ureters leading to the bladder rather than one—the infant needed constant medical appointments to keep tabs on her condition, a random defect that occurs during pregnancy.

Stressed and anxious, Deanna felt compelled to quit her job as a preschool teacher to maintain Audrina’s rigorous caregiving routine, which involved daily antibiotics and frequent temperature checks to ensure the baby didn’t develop a urinary tract infection (UTI)—an ever-present threat that could set off serious complications.

But in those fraught moments, the Middletown, New Jersey, mother knew she had an unwavering partner in care: pediatric urologist Aylin Bilgutay, M.D., and her colleagues at K. Hovnanian Children’s Hospital at Jersey Shore University Medical Center, who shepherded Audrina and her parents through myriad treatments and ultimately reconstructed the infant’s urinary system so she could live a normal life.

Serious Setback
Deanna learned her baby had a duplex collecting system at her 20-week prenatal ultrasound, knowing well before the birth that Audrina would need special care. But fate dealt some unexpected blows before the scheduled surgery to reconstruct the baby’s urinary tract at 14 months old. Testing on the newborn revealed she had a ureterocele, swelling at the bottom of one of the ureters that can block urine flow.

One morning, when Audrina was four months old, Deanna knew something was very wrong when the baby spiked a high fever. Testing by Dr. Bilgutay and her team showed a severe urinary tract and kidney infection, forcing them to try to decompress Audrina’s urinary system by puncturing the ureterocele. But there was so much inflammation surrounding the abscess that doctors could not successfully perform the procedure for nearly three weeks. Audrina spent this time at The Children’s Hospital on IV antibiotics.

Dr. Bilgutay stayed in constant touch, giving Deanna and her husband, Brandon, peace of mind.

“It’s a very severe issue because once bacteria gets into the system, it can’t adequately drain out,” Dr. Bilgutay says. “But even before the ureterocele puncture, we knew it would have to be fixed, or Audrina would be sentenced to lifelong issues with UTIs, fevers, sepsis or loss of kidney function.”

Successful Surgery
Ten months later, after continuous antibiotic therapy, Audrina underwent a five-hour surgery to reconstruct her urinary system. Dr. Bilgutay cut away the previously punctured ureterocele and reimplanted the two ureters leading from the girl’s right kidney to new spots in the bladder, ensuring no additional blockages would develop.

“We prefer not to remove any kidney tissue, so having two ureters is fine,” Dr. Bilgutay says. “When she’s 100 years old, she might need that extra bit of kidney function.”

Audrina’s quick and uneventful recovery culminated a few weeks later when two stents—tube-like devices that propped open her ureters as post-operative swelling abated—were removed. “The goal is to follow up on Audrina routinely, but I don’t expect any long-term issues for her,” Dr. Bilgutay says.

Now 3½, the preschooler learned to use the potty “like a pro” and does everything her peers do. She also has a little sister, Layla, who was born without any urinary tract problems. Audrina sometimes points to the now minor surgical scar on her belly and says, “That’s my superhero wound.”

“She doesn’t quite understand, but she knows she had a boo-boo, and Dr. Bilgutay fixed it,” Deanna says. “I tell her daily, ‘Do what you want to do and don’t let anyone get in your way.’”

Deanna and Brandon greatly appreciate Dr. Bilgutay’s reassuring manner throughout the ordeal. “You just don’t find other doctors like her,” Deanna says. “She was amazing.”

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