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Urinary Disorders

Hydronephrosis

10/20/2009

Question:

Twelve months ago I started having recurrent kidney infections, an ultrasound showed hydronephrosis in my left ureter+ enlarged kidney. It also showed my right kidney had cysts on it. An MRI and Cat Scan both failed to reveal what was causing the narrowing. I was getting antibiotics every two or three weeks and felt terrible, pain and neausa. A month ago they put a stent in the ureter, immediately I felt better, my urine flow was better and I had alot more energy. Last week I had surgery to have a camera put into my kidney, and at the same time they removed the stent. I am now back to square one, as two days after, I now have another infection. They are now saying that they think there is something external that is pressing on my kidney and I have to have further investigations. What could be pressing on it. They are really taking there time finding a solution and I don`t know how much more I can take.

Answer:

This evaluation should not take a year or months. If there is something external to the ureter which is pressing on it then that usually should be seen on a CT or MRI. If there is nothing there and you were better with a stent you may have scar within the ureter, a crossing blood vessel, an ectopic ureter which means that it enters the bladder at an abnormal area and causes a functional kink.

The solution may be to have a ureteral reimplant where surgically the is put into another spot in the bladder. Of course the treatment depends on the problem and if you are not happy with either the speed with which your problem is being taken care of or question the diagnosis a second opinion may be warranted.

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Response by:

Marc F Cymes, PA Marc F Cymes, PA
Clinical Instructor of Urology
School of Medicine
Case Western Reserve University