Opinion on Urgency for open surgery versus wait for lap procedure

[Jack411]

I have a blockage in one of my ureters that has caused it to enlarge severely.  My first occurance of this was early summer.  The ED assumed I had passed a kidney stone by the time I was seen and all pain and discomfort was gone so I guessed they were right.  Had another occurance about 6 weeks ago with bad pain and this time followed by lots of bleeding in my urine.  I was referred to a urologist who had another CT scan ordered, an IVP and various lab tests.  No stones were found, but I do have a sever blockage with a greatly enlarged ureter and kidney.  I had a cystoscope but they were unable to place a stent for drainage and could not even see what was causing the blockage.  

I have now been scheduled for surgery in two weeks.  I am concerned about waiting that long and if it is dangerous to leave the blockage with no drainage for that much more time.

Also concerned because my phys does not do laparoscopic procedures and told me he will make an incision basicly from the bottom of my rib cage to my hip bone.   He is going in to try and fix whatever is causing the blockage.  I was wondering is this typically an open surgery type case or should I be insisting on seeing someone who can perform this laparoscopicly (if I can wait the extra time for a referral).  The recovery from an open surgery like this would seem to be substantial.

Thanks

[keyzersoce]

I can only relate my experience. About four years ago, I had a ureter which was blocked. They performed a special nuclear study in which mildly radioactive material goes to your kidney and they can follow the glowing objects to see if they make it down through the ureter. That is how they could tell the glowing material on one side wasn't flowing downstream. There are special radioligists at the hospital who do nothing but insert stents all day in arteries, etc. They placed the stent in my ureter  through my right side, entering just below the kidney. A few days later, it was removed through a cystoscope procedure from the bladder end of the ureter.

In a case like yours, I would not hesitate to get a second opinion. Laporoscopic surgery is definitely the way to go for any procedure. You are right to be concerned about waiting that long for surgery.  When my ureter was blocked, the urologist told me it can cause problems, since the urine remains in your kidney and can leak into the body and/or cause infection. Talk to your doctor again and ask why there is a two-week wait. Maybe there is not a total blockage. But, I agree with bamagirl67 said; try to get it done laparoscopically, and ASAP.

[bamagirl67]

Recently I had a 3rd stent placed in my kidney to keep the tube from closing up.  This was done to "buy time" - to keep my kidney functioning long enough for me to be transferred to another doctor to do laparoscopic surgery.  My urologist said he could do the surgery but the hospital he uses does not have the equipment.  He recommended/referred me to a doctor that could do it laparoscopic.  

I've had 1 surgery already and personally I would prefer the laparoscopic if at all possible.  Talk with your doctor to see if you can be referred to someone that can do it laparoscopic but make sure the kidney will not be compromised in anyway while waiting on surgery.  See if there is a "temporary fix" until you can schedule the surgery and then have the surgery ASAP.