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Urology (Expert Forum)
deformation
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.
deformation
by kip, Nov 09, 1999 12:00AM
i posted question of invisible stones on july 15 99. continuing from that i have gone to another urologist and had another ct scan done and ivp again. the 12 mm stone is gone. now there 2 5x2 mm stones and a few small ones. prior to having these new scans done my new doc looked over the old scans and the first thing he noticed is that my left kidney (the one w stones) was dialated, so he ordered new scans and there was no change in kidney size in a one year period. the kidney walls are real thin and the bottom is tapered to a point like a caunch. would this be dialation due to stones or since there was no change in a year is my kidney deformed from some other cause, is it dangerous, and why does it hurt constantly now and i never felt it until i got stones 1year ago
Doctor's Answer
by hfhs M.D.-AK, Nov 15, 1999 12:00AM
Dear Kip,
Pain can occur in the kidney if the urine out-flow is inadequate. The outflow can be altered by an obstruction(stone), a congenital obstruction(UPJ), or a physiologic obstruction. The later, for example; if you consume alcohol, a diuresis occurs and increases the urine output. If your output is increased substantially as it does when you consume alcohol or other fluids in large quantities, you can have pains in the back, flank, or kidney due to the increased pressure in the system. The term for this condition is Dietl’s crisis.
Often this condition is associated with a borderline functional obstruction and during high rates of urine flow, the renal pelvis decompensates, resulting in severe abdominal pain and vomiting. When the pelvis drains sufficiently, the pain resolves. This is an intermittent condition and does not generally cause long-term damage to the renal parenchyma resulting in a loss of renal function. Other explanations for your problem include a UPJ obstruction, either stenotic or dysfunctional, or an accessory lower pole artery. However, in your case, you say that the kidney walls are thin, without seeing your X-rays, it is hard to comment, but it would be important to know how well your dilated kidney functions. This is important to see if intervention (surgery) is necessary.
In regards to what should you do? I would go back to your urologist Have him find out if the stones are causing the obstruction, or is this a congenital problem you were born with(UPJ obstruction), or a physiologic obstruction. A DTPA renal scan may help!
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword: Renal Colic
Pain can occur in the kidney if the urine out-flow is inadequate. The outflow can be altered by an obstruction(stone), a congenital obstruction(UPJ), or a physiologic obstruction. The later, for example; if you consume alcohol, a diuresis occurs and increases the urine output. If your output is increased substantially as it does when you consume alcohol or other fluids in large quantities, you can have pains in the back, flank, or kidney due to the increased pressure in the system. The term for this condition is Dietl’s crisis.
Often this condition is associated with a borderline functional obstruction and during high rates of urine flow, the renal pelvis decompensates, resulting in severe abdominal pain and vomiting. When the pelvis drains sufficiently, the pain resolves. This is an intermittent condition and does not generally cause long-term damage to the renal parenchyma resulting in a loss of renal function. Other explanations for your problem include a UPJ obstruction, either stenotic or dysfunctional, or an accessory lower pole artery. However, in your case, you say that the kidney walls are thin, without seeing your X-rays, it is hard to comment, but it would be important to know how well your dilated kidney functions. This is important to see if intervention (surgery) is necessary.
In regards to what should you do? I would go back to your urologist Have him find out if the stones are causing the obstruction, or is this a congenital problem you were born with(UPJ obstruction), or a physiologic obstruction. A DTPA renal scan may help!
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword: Renal Colic
