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Urology (Expert Forum)
pyelosplasty necessary?
Answered by
Kevin Pho, MD - Internal Medicine
Kevin Pho, MD
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.
pyelosplasty necessary?
by kh, Nov 18, 2003 12:00AM
My 6yr old daughter was recently diagnosed w/ "significant" hydronephrosis of her right kidney. I had taken her to the Dr. due to urinary frequency and the constant feeling of needing to urinate. After trmt for a mild UTI, the symptoms continued, and thats when the ultrasound revealed the hydronephrosis- I believe the left was 7cm and the right 10cm??. That was followed with an VCUG, IVP, and renal scan. The IVP showed what looked like severe blockage of the UPJ, and damage- however, as the Dr. said "I'm amazed at the preservation of her kidney- its remarkable" she had 46%function. But there is a drainage problem, and attributed it to a high-insertion ureter. It drains worse when she sits up. They have suggested pyeloplasty stating future function will deteriorate and other symptoms will be beginning soon. The past few weeks I've been asking her if she is having pain- they can't believe she hasn't been in pain- and now she admits to some pain in her lower right ribs- but she doesn't even want to talk about it. Do you think she has learned to deal with the pain?
Obviously, I really don't want to see her go through surgery if it is unnecessary at this time. Do you agree that damage will begin, and symptoms soon- or do you think we can wait and see? Any chance that this will correct itself? or that this is just the way her body is, and can function this was permanently? I truly appreciate your advice-
a torn mom
Obviously, I really don't want to see her go through surgery if it is unnecessary at this time. Do you agree that damage will begin, and symptoms soon- or do you think we can wait and see? Any chance that this will correct itself? or that this is just the way her body is, and can function this was permanently? I truly appreciate your advice-
a torn mom
Doctor's Answer
by Kevin Pho, MD, Nov 21, 2003 12:00AM
, Nov 21, 2003 12:00AM
Without being familiar with the case, I cannot make any recommendations as to what to do next.
With a blockage of the UPJ, the normal treatment would be a pyeloplasty. As you know, a pyeloplasty is the surgical reconstruction or revision of the renal pelvis to drain and decompress the kidney.
If the condition continues, it would certainly be possible that the kindeys would sustain more permanent damage. If your physicians feel that surgery is an option, it would be advisable as I am unaware of medications that can treat this.
If you are not comfortable with the surgical opinion, it would certainly be reasonable to obtain a second opinion before proceeding onto surgery.
More information on the procedure can be found here:
http://www.emedicine.com/med/topic3059.htm
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.
With a blockage of the UPJ, the normal treatment would be a pyeloplasty. As you know, a pyeloplasty is the surgical reconstruction or revision of the renal pelvis to drain and decompress the kidney.
If the condition continues, it would certainly be possible that the kindeys would sustain more permanent damage. If your physicians feel that surgery is an option, it would be advisable as I am unaware of medications that can treat this.
If you are not comfortable with the surgical opinion, it would certainly be reasonable to obtain a second opinion before proceeding onto surgery.
More information on the procedure can be found here:
http://www.emedicine.com/med/topic3059.htm
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.
