will kidney return to normal

[finkaz]

hi, can you tell me when there is a tumour on the ureter (which is not causing a total blockage of urine) but is allowing urine to trickle through without any problems, but is causing enlargement of one of the kidneys, will normal kidney function be damaged.  Also will the chemo cause problems for the tumour if it shrinks and if so what surgery options are possible.

[Annekathryn Goodman, M.D.]

Hi There,
A tumor that is causing a partial blockage of the ureter is a serious situation that is important to act on. The kidneys sit in the upper abdomen and in the back of the abdomen. The right kidny is behind the liver; the left kidney is just underneath the spleen. The kidneys make urine which then flows into a central region of the kidney called the renal pelvis. This area looks like a spout that then pours the urine into the ureters. The ureters are thin , muscular tubes the run from the kidney down the sides of the back of the abdomen  to the bladder.

At any location along the path of the ureter, a blockage can occur. For women who experience ovarian cancer, uerteral blockages can occur from an enlarged ovarian tumor pressing on the ureter, or from a tumor recurrence at the top of the vagina (the vagina is right behind the bladder), or from an enlarged lymph node along the pelvic blood vessels.

Depending on where the blockage is, the cause of the blcokage can be removed, or bypassed. If the blockage is from an ovarian tumor, it is important to operate, remove the ovary and so forth. If the blockage is from a recurrence of an ovarian cancer, it is usually not technically possible to remove the tumor without harming the ureter.

In that situation, a stent is placed into the ureter to keep it open. A stent is a small flexible tube that is inserted into the ureter through the bladder.

Sometimes, it is not possible to pass a stent because the ureter is too narrowed or compressed from the tumor. In that case, a nephrostomy tube should be performed. This involves placing a tube directly into the kidney through the skin on the back. The tube is then connected to a bag that collects the urine.

It is extrememly important to protect your kidneys from damage. Damage can occur if urine backs up in the kidney. This causes swelling and then destruction of the kidney tissue. The name of that is hydronephrosis. You need to have good functioning kidneys to be able to get chemotherapy.

If the tumor shrinks from the chemo, that is good and taht will not harm your ureters. Best wishes to you.