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Urology (Expert Forum)
Collic upper right anterior quadrant
Answered by
Kevin Pho, MD - Internal Medicine
Kevin, M.D.
Boston - MA
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
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Collic upper right anterior quadrant
by Bernardo, Feb 18, 2004 12:00AM
I am a 73 year old healthy, white male, 175 pounds. I suffered from a mis managed renal calculus procedure - 3 attempts to lasso the stone resulted in a grade 4 right reflux. My right ureter on film looks like a blown out inner tube. The doctor perforated my ureter. The stone was finally blasted.
It left me with a collicky(sp) pain when I urinate and now, eight years hence, I have that dull ache all the time. Upon exertion it gets very bad.
MRI and sonogram reveal a right hydonephrosis, creatinine 1.7.
My present urologist and internist scheduled a contrast CT scan but cancelled it when the saw the 1.7 creatinine.
I have had a TURP, no cancer and no prostate problems with a 4.2 PSA. I empty my bladder well ( leave about 50 cc) and am not troubled by frequent urination.
I want to find out why I have the dull pain under the right costophrenic area. It does not radiate through to the back and I have no dorsal or lumbar pain. I am very active am otherwise in good health. Don't believe it is gall bladder related as there is no correlation to food intake.
I do take flotx and 10mg lipitor, though my HDL is 59 , LDL 95, risk ratio 2.8. Homocysteine is 13.5; cardio CRP 5.9. I will have an angiogram at my internist's suggestion due to a small irregularity he saw after a stress test. No other drugs.
Thanks for your thoughts on trhe mattter.
Bernie Rogoff
Can you suggest a protocol I can use to reveal the extent nature and extent of my pain.
It left me with a collicky(sp) pain when I urinate and now, eight years hence, I have that dull ache all the time. Upon exertion it gets very bad.
MRI and sonogram reveal a right hydonephrosis, creatinine 1.7.
My present urologist and internist scheduled a contrast CT scan but cancelled it when the saw the 1.7 creatinine.
I have had a TURP, no cancer and no prostate problems with a 4.2 PSA. I empty my bladder well ( leave about 50 cc) and am not troubled by frequent urination.
I want to find out why I have the dull pain under the right costophrenic area. It does not radiate through to the back and I have no dorsal or lumbar pain. I am very active am otherwise in good health. Don't believe it is gall bladder related as there is no correlation to food intake.
I do take flotx and 10mg lipitor, though my HDL is 59 , LDL 95, risk ratio 2.8. Homocysteine is 13.5; cardio CRP 5.9. I will have an angiogram at my internist's suggestion due to a small irregularity he saw after a stress test. No other drugs.
Thanks for your thoughts on trhe mattter.
Bernie Rogoff
Can you suggest a protocol I can use to reveal the extent nature and extent of my pain.
Doctor's Answer
by Kevin Pho, MD, Feb 20, 2004 12:00AM
, Feb 20, 2004 12:00AM
If you already had an MRI of the area, and the only finding is hydronephrosis, then it is unlikely that there is any further anatomical abnormality that is causing your symptoms. Hydronephrosis itself can cause the discomfort.
You may also want to consider a GI source of pain if the kidneys have been ruled out. Causes of right sided abdominal pain can include irritable bowel sydrome or inflammatory bowel disease. Comprehensive tests to evaluate this would be a colonoscopy and upper GI series with small bowel followthrough.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
You may also want to consider a GI source of pain if the kidneys have been ruled out. Causes of right sided abdominal pain can include irritable bowel sydrome or inflammatory bowel disease. Comprehensive tests to evaluate this would be a colonoscopy and upper GI series with small bowel followthrough.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
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