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Urology (Expert Forum)
Ct scan abnormality
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
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.
Ct scan abnormality
by TCN, Feb 04, 2006 12:00AM
I thankyou so much for your time. I hope you can give me some insight. I am 37f. I was just released from the hospital due to a heart related problem. Pacemaker dependant. I take aldactone, and lasix as needed. While in the hospital, due to abdominal swelling and chest pain, I had a CT scan. It showed dilation of kidney tubules (whatever that means). Over the past 3yrs. or so I have been followed by a nephrologist because of swelling, extremely high renin and aldosterone, and low potassium. I get periodic swelling of head and neck and feel like my head is very full.
The urologist ordered a lasix flow study and said my problems with high renin, periodic hypertension etc. could be due to a blockage pressing on the angiotensin system (something like that). I had the scan. It showed that the flow was normal.
Now here are my questions:
One kidney is significantly smaller than the other, working at 30%.
Is that normal?
I had polynephritis as a child, and a few bladder infections over the years with hematuria.
The urologist wants to do a cytoscopy. Would that show something different than the renal scan?
Does the normal flow eliminate the possibility of blockage, and the possibility it is linked to high renin?
I did have a renal cath. No renal artery stenosis.
One other important symptom. Over the last few months, maybe 2 or more, I have had a change in urine flow. Sometimes it takes a while for it to start and I have to push very hard for anything to come out. It is slow, and I often feel that my bladder isn't fully emptied. While in the hospital they did a bladder scan. I went 400 ccs. and was left with 250ccs.
Should I follow up with my nephrologist, or go the urologist or just let this go?
Any insight would be extremely helpful.
Thanks so much!
The urologist ordered a lasix flow study and said my problems with high renin, periodic hypertension etc. could be due to a blockage pressing on the angiotensin system (something like that). I had the scan. It showed that the flow was normal.
Now here are my questions:
One kidney is significantly smaller than the other, working at 30%.
Is that normal?
I had polynephritis as a child, and a few bladder infections over the years with hematuria.
The urologist wants to do a cytoscopy. Would that show something different than the renal scan?
Does the normal flow eliminate the possibility of blockage, and the possibility it is linked to high renin?
I did have a renal cath. No renal artery stenosis.
One other important symptom. Over the last few months, maybe 2 or more, I have had a change in urine flow. Sometimes it takes a while for it to start and I have to push very hard for anything to come out. It is slow, and I often feel that my bladder isn't fully emptied. While in the hospital they did a bladder scan. I went 400 ccs. and was left with 250ccs.
Should I follow up with my nephrologist, or go the urologist or just let this go?
Any insight would be extremely helpful.
Thanks so much!
Doctor's Answer
by Kevin Pho, MD, Feb 06, 2006 12:00AM
, Feb 06, 2006 12:00AM
To answer your questions:
1) Having a smaller kidney operating at 30% is not normal.
2) A cystoscopy is the most comprehensive test of the lower GU tract. It can show anatomical changes that may not be seen during a renal scan.
I would follow through with the cystoscopy and evaluate the kidney function further with a nephrologist. The urine sediment should be analyzed under a microscopy, and kidney function montored via blood tests.
A kidney biopsy can be considered if the diagnosis remains elusive.
These options can be discussed with your personal physician.
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_b
1) Having a smaller kidney operating at 30% is not normal.
2) A cystoscopy is the most comprehensive test of the lower GU tract. It can show anatomical changes that may not be seen during a renal scan.
I would follow through with the cystoscopy and evaluate the kidney function further with a nephrologist. The urine sediment should be analyzed under a microscopy, and kidney function montored via blood tests.
A kidney biopsy can be considered if the diagnosis remains elusive.
These options can be discussed with your personal physician.
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_b
