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Urinary Disorders

Previous UPJ resolved- 4 years later symptoms

12/03/2008

Question:

I was diagnosed with a UPJ obstruction 4 years ago. The open pyeloplasty failed to resolve the obstruction, went to a new urologist who did fix it. In the last three weeks I`ve suddenly had consistent pressure and intermittent pain on the same side. I`m waiting to see my Urologist- but am in extreme pain. I did get an IVP done on Friday and the Radiology report came back with the following: "Impression: Findings compatible with postoperative changes of a congenital right ureteropelvic junction obstruction. Mild caliesctasis and moderate dilatation of the renal pelvis persist without significant change on voiding. Small postvoid residual volume in urinary bladder." Can you tell me what this means? Am I obstructed again? How many times can you repeat a peyloplasty before there`s too much scar tissue?? Please help, I feel quite desperate at this point.

Answer:

It is difficult to determine if you are obstructed from the IVP report alone without comparing it to previous films. It may be worth obtaining a nuclear renal scan with lasix to help determine if there is persistent mechanical obstruction and to evaluate the differential function of the kidneys. Because of the discomfort in the side, I would suggest that you contact your urologist and be evaluated.

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Response by:

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