Kidney Pain after pyeloplasty and removal of stent

Question

My son had a pyeloplasty nearly two months ago to correct a UPJ obstruction and severe hydronephrosis.  Since the surgery he has complained of flank pain.  We were told by the urologist that once the stent was removed that the pain and inflammation should subside.  While the stent was still in, i had taken my son to the ED for severe pain 5 times, it actually mimicked the pain that he had pre-op.  The stent was removed 5 days ago and he has since had kidney pain.  He is on pain medication to deal with the severe pain.  Last night we once again ended up in the Emerency Room.  The urinalysis and blood work showed no infection or abnormality.  He also had an ultrasound and the kidney has decreased in size.  So, with no infection present and kidney function is actually improving, what could be causing the severe pain?  He is only six years old and it kills me to have to see him go thru this

oppa6005 · Answer

Hi my son is 5 and was finally found to have UPJ obstruction after years of these episodes and trips to the ER! Let me ask you a question; do you think your son is actually constipated or do you think that is just what the drs first theory is. I was told for years that's what was causing these pains and after numerous enemas and suppositories and nothing ever really coming out, I realize it was never constipation my son had! The drs just didn't want to admit they were wrong! My son had robotic pyloplasty. He had severe complications causing him to be in the hospital for weeks. We got out of the hospital and he had 4 episodes with the stent in. He had the stent removed 3 weeks ago and has had one episode. We go for an ultrasound in a couple days but considering he is still having the episodes it's hard to be optimistic about what we will see. My dr did give him Toradol and told me to crush it as soon as the episode starts and WOW! It knocks the pain out immediately! It's the only reason I am able to keep calm about all this.

mayank12121 · Answer

hi i am 23 and have been through upj pyleoplasty twice 2005(age 10yrs) and again in 2009. i don't know why upj happened again because doctors didn't said that first time was failure but said it was the best anybody could have done and second time they said now its 100% success. since then i am always in pain, problem is that i can feel my ureter from kidney to urinary bladder and it makes me uncomfortable all the time, its like a burning sensation inside & this sensation was unbearable when i was a teenager but now i think i am habitual to it. and i also feel some strange sensations like something is moving there or like some kind of fluid is leaking out with bubbles and strange sound which only i can feel inside my abdomen on the same spot where it pains. i have been through diagnosis  many time for this but nothing came out they say everything is normal.so what they do during pyeloplasty is cut down the affected area of ureter and remove it than stitch its two open ends again, which makes ureter a bit smaller, so during stretching or any kind of physical activity it pains and a cramp like situation arises inside and this is most painful of all, i think doctors know everything but usually don't share every aspect in a comprehensive manner and since abnormality is already in the organ which could lead to 'n' number of pains, sensation or whatever we want to name them. so every pain can't be cured.

KorynV · Answer

In August 2017, I had a UTI that turned to a kidney infection. I went to the ER and found out that my right ureter was obstructed from a birth defect. The kidney was swollen and full of infected urine, aka a bomb. They put a stent in and said i'd need surgery on the Ureter obstruction. I had my pyeloplasty done in November and went home with a catheter for 3 days. I went back to the ER in immense pain ( to say the least) with what turned out to be a kidney staph infection (most likely due from the surgery or catheter itself). After a few days, I got better but the pain persisted at a controllable level until January. Finally, I went to a 24hr emergency clinic where they said I have a UTI and need to go back to the ER. They said there might be something wrong with my surgery. At the ER, they ran tests and said the pyeloplasty was successful and my right kidney is draining- slowly and delayed but it is draining. Also turns out that the staph infection never went away or just developed into MRSA. I was treated in the hospital and put on Linezolid ($3000 antibiotic for 14 days). Needless to say, I needed a lot of yogurt and probiotics. After my 14 day regimen, they said I do not have an infection- tested by simple UTI test.

Anyway, it's now March and my kidney is still hurting. It's bearable but I wake up or go to sleep with my kidney in pain. I suppose it's hydronephrosis and it's expected.

Bgrussell26 · Answer

Hi I hope your son is doing better. Unfortunately for me hydronephrosis and upj obstruction has been a life long battle and a daily struggle. I was diagnosed as a baby and it was caused by a birth defect which was a major artery and vein wrapped around my ureter. My kidney has continued to decrease in function and pain episodes are daily along with severe constipation/diarrhea, vomiting, uti's, peeing blood, headaches, dry skin, itchy skin, terrible flank and abdominal pain.my symptoms always get way worse if I happen to get constipated or dehydrated or if my monthly cycle starts. My urologist says this happens because these three issues cause major inflamation in the body which caused pain and swelling and poop rubs against my kidney or bladder or ureter and caused the pain. Hopefully that explains it for you maybe? I have gotten stents placed all the last year and my symptoms decreased drastically so bc of that I finally got a pyeloplasty to correct the birth defect.also things that help is physical therapy on my pelvic floor muscles and my core,having these muscles be extra strong helps decrease the pain and amount of pain episodes. I also drink 96-100 ounces of water daily before I drink anything else. High water intake helps me rid extra inflamation. My doc put me on torodol 50mg every 6 hours and anti-inflamatory drugs which is really helping. I'm current 22 years old and 4 weeks post op with stent placed still. I'm expecting to have the stent pulled in another 4 weeks. I'm praying for your children. No child deserves this. Stay strong mommies. This will end!

Rambozo · Answer

I should add that she's always been constipated most of the time. Which is why your message struck me. Do you still think there may be a link?

Rambozo · Answer

Hi JMoraga,

Has the source of your son't pain been found and fixed? (I hope so)

Why wer're interested: couple of months ago my girlfriend had a pyeloplasty to correct an UPJ obstruction. She still feels the kidney that was enlarged, it sometimes stings, and she's worried.

Her blood work came back ok and now the doc is going to have a CT scan taken, but he's certain that there's no problem, he seems to be just doing it to reassure her.

jnremeta · Answer

My son was diagnosed with unilateral hydronephrosis and UPJ blockage at 6 years old. He has now had two surgeries and still has pain and severe hydronephrosis. We are currently working with his pediatrician to get an appointment at one of the larger diagnostic hospitals as I just don't feel his urologist has this in hand at all.  That being said, I know I was told too much activity or any impact could cause blood in the urine as well as pain, fever, etc after surgery. Was he especially active the day before or anything like that? Have they tested your son for VUR? Either way I would call the urologist office and let them know he was having these symptoms and find out if they can work you in any sooner. Throughout my son's experiences he has never had a UTI, but he continues to have pain and issues.

Ms_MS · Answer

My son was diagnosed with hydronephrosis and UPJ obstruction before he was born. Once he was born he had no complications. He never complained of pain, he never had UTI's. He had no problems so I had a hard time consenting to allow the surgery. Once he was three and I had a good idea of the eventual problems as a teen he would face, and after many trips at six month intervals for them to monitor his kidney function....with the kidney constantly growing and threatening rupture or failure, I allowed the surgery. he was three years old. He came out of the surgery, was fine, two weeks of aftercare at home and he had all the tubes pulled. Since then he's done an ultrasound every year. These all showed fine each time. The kidney was still slightly large but no reason for concern. Now he's six and one day he had a sore urethra and a clear drip. We were told he had no UTI. Then he got sick, had a fever, vomit and diarrhea. He then started urinating blood. Took him to the ER and they could find no infection. His urinating blood suddenly stopped and he seems fine. I have no idea what could cause this. His appointment is a few months almost away. What could be causing this? Any ideas?

lindahand · Answer

This is an old post so unfortunately you will likely not get an answer. You may want to try posting it as its own post and see that way. For constipation dried prunes worked well for me and are sweet so he'll likely eat them. I was on pain killers that caused major constipation and if I eat some of those each day it would help a lot.

JMoraga · Answer

Here we are, nearly 10 months after surgery.  My son had a good 6 months with little or no flank pain.  About 2 months ago, the pain started once again.  I was told that it seemed as though it was not the kidney this time but constipation... My son has had the problem with constipation since he was about 2 months old and since the surgery has been on and off of miralax to help with the symptoms.  A few days ago, we ended up back in the Emergency room, the pain had my son crying and holding his side just as he did prior to his pyeloplasty.  They did an x-ray and confirmed the constipation but also did an ultrasound and confirmed the hydronephrosis to be back but that the kidney function was actually good.  I do not understand what the correlation is between the constipation and the kidney function but it always seems when one symptom is present, the other shows as well.  After leaving the ER, I was told to increase fluid intake, limit greasy foods and increase the miralax dosage.  He has for the most part seemed fine since.  We do have to follow up with the urologist within the next few days.  It is just beyond frustrating to continue dealing with seeing your child in pain after the surgery to remedy the situation has been completed.  What is the outcome of your sons situation?  I know that the hydronephrosis will be present due to the kidney being damaged but is there any remedy to the symptoms?

jsom · Answer

Hi! I know the pain and the frustration you are experiencing.  My son (5) had the laproscopic pyeloplasty Oct 2011.  The nephrostent was pulled a week and a half later and within hours he was having symptoms of obstruction just like before surgery.  We went into the urologists office the next morning and an ultrasound showed his kidney was huge again.  They placed a stent that same day and we went home.  Even with the stent he was experiencing stomach pain on and off.  They removed the stent the last week of Dec. 2011 and once again he was showing signs of obstruction by the next day.  The next day an ultrasound showed his kidney was huge again to they placed a nephrostomy tube in his back to relieve his symptoms until we were able to discuss with the urologist on what action to take next.  When we met with the urologist he deceided to do the open pyeloplasty to get a better open visual picture of the obstructed area.  He had the open pyeloplasty Jan 2012 and we are almost two weeks out.  Two days ago we had a nephrostogram and none of the dye went thru his ureter.  So we are waiting to see if the swelling go down from sugery and hopefully the ureter opens and works.  I would like to hear more about your story and any other steps you have taken since Nov. 2011.  I have been researching non-stop to see other ways to help relieve his obstruction without more surgeries.  I truly sympathize with you since I know what an emotional roller coaster this whole process is when your part of the % that has problems.  Looking forward to hearing from you!