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Urology  (Expert Forum)
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cystoscopy damaged ureter / dilated kidney
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.

cystoscopy damaged ureter / dilated kidney

by Scootz, Jun 21, 2006 12:00AM
On the 16/08/05 my partner - X - (33 yrs) collapsed in agony at home. Prior to this he had never had any problems.  We gave the doctor urine samples and were told that he had a lot of blood in his urine and something was wrong with his kidneys. He was in immense pain so I rushed him to A & E.

      The Urologist concluded that he may a kidney stone & needed an emergency operation as his right kidney was swollen twice the size of the left. Under general they inserted a stent & tried to perform a Cystoscopy. After the operation the surgeon explained that they had accidentally pierced his ureter. A few days later whilst in hospital he collapsed again & the medical team inserted a catheter. The catheter remained in place for 6 weeks. A couple of weeks after my partner had a follow up X-ray & the radiologist mentioned how swollen X’s right kidney was. However, when X asked the urologist he said there was nothing to worry about.

   A few weeks later X collapsed again. I rushed him back to A&E. He had X-rays CAT scan & ultra sound. After the 3rd night he was informed that an operation would be performed to insert a J stent & an attempt would be made at a Cystoscopy. The morning of the intended operation the urologist told X that the operation was canx. The urologist said that he was to refer X to a chiropractor as the pain wasn’t his kidneys. He was informed it may be up to 3 days before the chiropractor would be available. As X had been in hospital for 8 Days he requested a discharge & explained that he would see the chiropractor as an outpatient. The urologist agreed that this would be the best way forward & discharged him.

     X went to a back specialist. The specialist said that the pain would go away with some stretching exercises which he carried out for 6 weeks and returned to work. The pain remained immense.

     X went to a private urologist for a second opinion. After an initial consultation the urologist put X on pregabalin (Lyrica) medication. The medication incapacitated X & he had to stop working as he couldn’t drive in his state. Over the next few weeks X had an MRI scan. The urologist said that nothing was revealed & referred X to a back specialist. The back specialist said that nothing was wrong with his back & presumed that it was a urological problem. The Urologist then referred X to a pain specialist.

       We took the MRI scan images to the pain specialist who put the images up on the screen and immediately declared that the right kidney is dilated & insisted he showed us the scan. X explained the history of his pain. The specialist then said that a course of acupuncture would relieve the pain as he has neurpathic pain.

     I need to know if a dilated kidney is a serious problem and if you have a dilated kidney would the acupuncture cause further problems,X is due to have Segmental Acupuncture and if that doesn’t work Dorsal Root Ganglion Pulse Radio Frequency Lesioning. Is it bad to take pregablin with a dilated kidney?

by Kevin Pho, MD, Jun 21, 2006 12:00AM
It is difficult to comment without evaluation.  



If there is evidence of kidney enlargement, a stent would help with this.  It is very possible that the pain continues to be caused from the enlargement.  You may want to inquire whether a stent could help with the symptoms.  



Acupuncture can help mask the symptoms and pain, but if the underlying pathology isn't corrected, the pain eventually will continue.  



I would also ensure that the kidney function isn't affected.  Blood tests to evaluate the creatinine can be done to evaluate this.  There are uncommon cases of this medication leading to renal failure, so if there is already kidney damage you can discuss whether this medication can be stopped.  



These options can be discussed with your personal physician or urologist.



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.



Kevin, M.D.

kevinmd_
Member Comments

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