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Urinary Disorders

Pain in Kidney After Pyeloplasty with Robot

02/18/2009

Question:

Hi I am 41 year old female. I had the surgery for hydronephrosis on Dec. 9. When my surgeon got to my ureter he found that a vein and an artery were squeezing my ureter tube...He fixed the problem. I got my stent out last week and my kidney hurts. Pain is moderate but it is still there. My surgeons` nurse tells me that this is in my head. I am dizzy and the fatigue and low grade temp. I have done all the cipro. I have a renal scan scheduled for April but I hurt now. Is this normal or should I seek a different opinion? I went to my primary doctor and all blood and urine came back normal except for inflamation showed up. My number was 51 and she said 20 is normal. She has put me on antibiotics for 3 weeks and is treating me for a chronic sinus infection. I dont feel that this is the problem but I will do it. I am just worried about my kidney. I am urinating like a champ so I dont feel there is any problem with the function of the kidney but something just isnt right.

Answer:

Pain after pyeloplasty could be related to post operative recovery from inflammation related to the surgery or due to reobstruction (there is always a small possibility of failure of the pyeloplasty procedure). If the pain is persistent and bothersome, then a earlier repeat lasix renal scan could be helpful in assessing the drainage from the operated kidney (could be compared to the preoperative renal scan).

Sometimes there could be transient swelling/inflammation from the surgery at the pyeloplasty repair site causing some temporary obstruction. This could show up as obstruction on the renal scan and could require restenting for a while (based on the clinical situation), followed by removal and reevaluation of the success of the procedure (based on relief of symptoms, renal scan).

Urinary tract infection is the other possibility that could be evaluated with a urine culture and treated with the appropriate antibiotics if required. One of the other symptoms sometimes associated with kidney infection is fever, which I assume you do not have as per the information that you have provided. I hope you find this information useful. I would suggest that you discuss your symptoms/concerns with your urologist so that he/she can evaluate you accordingly based on your clinical situation.

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Response by:

Krishnanath  Gaitonde, MD Krishnanath Gaitonde, MD
Assistant Professor of Clinical Urology
College of Medicine
University of Cincinnati