Questions posted in the The Urology Forum have been answered by urologists from Henry Ford Health System and by Dr. Kevin Pho.

Question Title: kidney stone,rotated kidney

Forum: The Urology Forum
Topic: Kidney/Urinary Stones

After several years of pain in my right side(front,back)& several surgeries(hystorectomy,appendectomy,gall bladder removal),It has been discovered that I have a rotated kidney. A small stone was also found,but I was told that it would probably
never move because of its location.I've had 2 or 3 IVP's,they checked my bladder(cystoscopy?) & done a CT scan.Last week I had symptoms of a bladder infection again.A UA was done & found +3
blood cells(?) in urine,but no infection.Also each time blood is found in urine,
my BP is elevated.It really got to be stressful last time,because of finances and just plain not finding anything out!
I am going to do this next IVP,but if nothing is found, I don,t think I can do the rest again.Do you have any suggeations as to where to turn? The pain is constant,dull.It generates from my rib cage,sometimes going as far as my bladder where I feel the pressure to urinate. I do seem to be voiding more often & larger amounts.Moderate hydronephrosis was also diagnosed.I must add,it almost feels muscular & sometimes massage or chiropractic adjustments help,but sometimes not. Thank you for your time.

Dear Jan,
Your question can be divided into four basic issues: kidney stone, hydronephrosis, kidney malrotation, and microscopic hematuria. These may or may not be related. It is possible to be born with a kidney that is out of position(malrotated) that does not drain properly (hydronephrosis), and that the stasis of urine can cause stone formation and resulting hematuria (blood in the urine). However, kidney stones, hydronephrosis, and microscopic hematuria are not uncommon even in the absence of microhematuria.
In regards to the microhematuria we agree with the IVP and cystoscopy, but would also suggest a urine cytology to look for cancer cells. The kidney stone should be treated if it is larger than 1 centimeter, if it is thought to cause the hydroneprosis or pain. The malrotation is usually left alone. The hydronephrosis can be further characterized with a diuretic renogram study to see if obstruction of the flow of urine exists. This may help explain if your pain is kidney related. If there is obstruction, then surgical intervention is warranted to prevent further kidney damage and to releive pain.
This information is provided for general medical information purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available through our department at the Henry Ford Hospital and its suburban locations (I-800-653-6568).
Sincerely;
HFHS M.D.-CK
* Keyword:malrotation, hydronephrosis, kidney stone, microhematuria
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