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Urology (Expert Forum)
Flank pain - please help!
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.
Flank pain - please help!
by Brea2001, Mar 12, 2004 12:00AM
I am a 29 year old female with severe pain in my left flank area that sometimes travels down to my left fromt abdomen(groin area?). Sometimes the pain comes on very sharp- like someone is stabbing me and othertimes it is constant like a fist is pushing against my left kidney. At 16 yo I had surgery to correct bilateral reflux-(I didn't have symptoms of reflux- this was caught by accident when I had an ovarian cycst at age 15). This left me with a smaller, scarred left kidney. Since then I have had increasing amount of kidney infections. 2 years ago I had 5 kidney infections in a year. They put me on daily antibiotics and sent me to a urologist. During a routine visit my left kidney was sore (start of the pain). About as month later I got a stabbing pain out of nowhere- I literally fell to the floor. Dr thoguht it was kidney stones, but all tests came back negative. Since then I have been dealing with this pain. I have had many tests (IVP, CATscan, check for reflux, blood work) and all have been negative. They also did a nuclear scan showing left kidney function at 24% (said it was a good number for the size of the kidney). Last July, following a hunch, my DR put in a stent to the left kidney and this helped a lot. Pain disappeared for a couple months. In January I had another kidney infection (2 rounds of antibiotics- cipro and levaquin) and the pain came back. I had another nuclear scan and now left kidney function is downto 20% (in less than a year) and decreased blood flow to this kidney. I am going in for a Whittaker Test on Monday. What will that show? DR is talking about removing my left kidney, but doesn't want to until he is sure why I have the pain and why kidney is deteriorating.
I would like your opinion on what could be going on. What could be causing the function of my kidney to be decreasing? Why am I getting pain like there is a stone when everything is negative? I would like to start a family, what would having the kidney removed do to those plans? If they can't find a reason why my left kidney is failing, then how do I know my right kidney won't fail also? My blood pressure is excellent. No proteins or anything in my urine. My creatinine is 1.2. I have been told that everything looks greats- except for my pain. The only way I can get through the day is by taking percocet, but I hate taking them. I have tried many other pain killers, but they don't work. I am exhausted, but I don't know if that is a symptom or a result that the pain wakes me up during the night. Also, somedays i fell the need to urinate almost constantly. Sometime even though I just finished going. Other days they urgency isn't there. And, since the kidney infection in January I have been retaining a lot of water. I would appreciate any insight you may have.
I would like your opinion on what could be going on. What could be causing the function of my kidney to be decreasing? Why am I getting pain like there is a stone when everything is negative? I would like to start a family, what would having the kidney removed do to those plans? If they can't find a reason why my left kidney is failing, then how do I know my right kidney won't fail also? My blood pressure is excellent. No proteins or anything in my urine. My creatinine is 1.2. I have been told that everything looks greats- except for my pain. The only way I can get through the day is by taking percocet, but I hate taking them. I have tried many other pain killers, but they don't work. I am exhausted, but I don't know if that is a symptom or a result that the pain wakes me up during the night. Also, somedays i fell the need to urinate almost constantly. Sometime even though I just finished going. Other days they urgency isn't there. And, since the kidney infection in January I have been retaining a lot of water. I would appreciate any insight you may have.
Doctor's Answer
by Kevin Pho, MD, Mar 13, 2004 12:00AM
, Mar 13, 2004 12:00AM
A Whitaker's test is a simultaneous recording of pressure in the renal pelvis and bladder to identify the presence of obstruction.
There are many reasons why the kidney function can be decreasing. This can include obstruction or intrinsic kidney diseases (such as glomerulonephritis, acute tubular necrosis, or other hereditary kidney diseases). To further determine the cause of kidney function loss, you may want to obtain an opinion of a kidney specialist (nephrologist) - which differs from a urologist. A kidney biopsy can be considered for further evaluation.
To answer your other questions:
1) I do not have a definitive answer as to why you are still receiving pain. Further imaging tests such as an MRI may help.
2) Removing one kidney should not preclude you from starting a family.
3) Certainly a diagnosis should be made before taking the left kidney out - you are correct in that there is no guarantee your other kidney won't fail as well.
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.
There are many reasons why the kidney function can be decreasing. This can include obstruction or intrinsic kidney diseases (such as glomerulonephritis, acute tubular necrosis, or other hereditary kidney diseases). To further determine the cause of kidney function loss, you may want to obtain an opinion of a kidney specialist (nephrologist) - which differs from a urologist. A kidney biopsy can be considered for further evaluation.
To answer your other questions:
1) I do not have a definitive answer as to why you are still receiving pain. Further imaging tests such as an MRI may help.
2) Removing one kidney should not preclude you from starting a family.
3) Certainly a diagnosis should be made before taking the left kidney out - you are correct in that there is no guarantee your other kidney won't fail as well.
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.
Member Comments (2)
by Mossie, Apr 08, 2004 12:00AM
To: Urology - General
0
by Brea2001, Apr 20, 2004 12:00AM
To: Urology - General
0
by Brea2001, Apr 20, 2004 12:00AM
To: Urology - General
0
by drpepper, Apr 22, 2004 12:00AM
To: Urology - General
0
by flyinggee, Sep 10, 2008 12:04PM
A related discussion, Bilateral chronic flank pain was started.
