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Urinary Disorders

Do I need a second opinion

10/28/2008

Question:

I recently had a baby on Sept 10th 2008. 4 mths into the pregnancy my right kidney became completely blocked by the uterus pressing up against it, prior to that I had never had any urinary or kidney problems. I was referred to a urologist by my obgyn and the decision was made to place a urinary stint to drain the kidney but it was so painful that it was removed and a nephrostomy tube was put into the kidney instead for the remaining three mths of my pregancy. The day after I had my baby the tube was removed because the x-ray showed no blockage, however two weeks later I was in the emergency room with flank pain and It turned out to be filling up with urine again so I was sent home with pain medicine and told to follow up with my urologist. They decided to do an IVP and the IVP showed that while there was no fluid in the kidney it was significantly larger than the other one because of all the fluid build up. I have been in the ER twice since then with severe pain in that same side and once I was diagnosed once with a urinary tract infection but the urologist don`t understand why I am having so much pain in that side. Could this be scar tissue from the nephrostomy tube because the urologist says that the scar tissue should have shown up in the IVP but that they didn`t see any and should I be seeing a Nephrologist or an Urologist for this problem because this pain is becoming unbearable at times and I`m tired of trips to the ER. Help.

Answer:

It is unlikely that the pain is from the prior nephrostomy tube. Depending on the findings of the IVP, further imaging can be obtained if warranted. I would suggest that you discuss these issues with your urologist. If the imaging is negative, you may wish to discuss nephrology referral with your urologist.

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Response by:

Donald R Bodner, MD Donald R Bodner, MD
Professor of Urology
School of Medicine
Case Western Reserve University