Pelviuretic obstruction

[JohnBates]

I just had a CT Scan Urogram.  The comment states that "Preliminary plain scans demonstrate no evidence of renal, ureteric or bladder calculi.  There are numerous calcified phleboliths in the pelvis.  Scans obtained following contrast demonstrate no abnormality in the right kidney, pelvicalyceal system or ureter.
There is noted to be a cortical cyst arising from the medial cortex of the mid to lower portion of the left kidney measuring 3.3cm in diameter.
There is mild dilatation of the left renal calyces and of the left renal pelvis.  The left ureter can be seen arising from the mildly dilated left renal pelvis and appears of normal diameter.  Features suggest a mild pelvi-ureteric junction obstruction.  The previously noted cortical cyst is noted to lie immediately adjacent to the left pelvi-ureteric junction.
The left kidney otherwise appears normal.  No abnormality is noted in the left ureter.  The left kidney does not appear to be duplex and there is a solitary left ureter.
There is noted to be a small fat containing umbilical hernia.
No Additional abnormality has been demonstrated.
Comment:
Features suggest a mild left sided pelvi-ureteric junction obstruction most likely idiopathic although there is noted to be an adjacent cortical cyst measuring 3.3cm in diameter. The left Kidney is not duplex."

I have been on Feldine 20 – 2 per day and Panadine Forte 4 per day.  I have stopped the Feldine though my joints are hurting a lot.

My health otherwise seems to be ok other than my resting heart rate lately has been 160 over 110 and pulse is 110.  I have done a lot of bicycle riding 20 Km per day. Appetite is normal. In the last week my BP has been 140 over 90 and pulse 60.

I have small to mild pain in the left lower abdomen but I can live with that for a while.  I have been drinking approx 4 litres of water a day and can not seem to quench my thirst.  I have had my BSL tested and am not diabetic. How long before this becomes a real problem?  Do I need to get the surgery done or can it wait 6 months or so?  Am I able to drink alcohol or will that do more damage?  Is there anything I can take to alleviate the problem?

Thank you


John Bates

[karajo]

John, pelvi-ureteric junction obstruction and ureteropelvic junction obstruction is the same thing.  It is where the kidney (renal pelvis) and the ureter meet.  This is the most common obstruction.  I was told 6 months ago I had hydronephrosis and a mild UPJ obstruction.  I was throwing up and in severe pain.  I guess they wait until you are an invalide before they do something about these things.  

It sounds like we have the same problem.  An intermittant UPJ obstruction.  They will chase that thing around and drain your pocket book doing it.  Some sound advice is to get a diuretic renogram while the symptoms are acute.  Make sure you are well hydrated for the test, as this is part of the stress factor.  They won't do anything about your condition until the ureter is proven totally obstructed.  Another test that would show detail in the kidney and ureter is a retrograde pyelogram.  They put me to sleep for this 'cause they did it right before my hysterectomy last Dec.  I'm glad I was asleep.  

check this web site out:
http://pediatrics.aappublications.org/cgi/content/full/117/1/139

I wouldn't be drinking alchol if I were you.  Water is the best thing right now.  No tea or coffee.  You probably will find that they will cause you problems as they are all diurectics.

The kidney is a very resilliant organ.  It is suppose to bounce back after lots of abuse.

I'm praying for you.

[JohnBates]

Thank you for the comment.  I am 36 years old and I think that it can wait untill it becomes a real problem.  Have you found with this problem that exercise becomes a lot harder?  I used to drink a lot of diet softdrink but with recent media coverage linking the sweetners to kidney problems, I have also stopped drinking these.

I would like to go back on the Feldine but this is probably what caused the problems in the first place.  Feldine is a good anti-inflamitary, up ther with Viox, but it has a nasty habit in hammering the kidneys hard.  I have been taking Feldine for 10 years and it is only recommended for a max of 6 months.

The cost of the operation and further treatment is not a problem in Australia.  The Government looks after us well.+ I have good private health insurance where it will not cost me anything.  I do not want to wait untill I am throwing up and in severe pain to get somthing done.

What advice would you recommend?

John

[karajo]

Yes, I can hardly walk most days.  Excercise has not been an option.  

Diet drinks are just really bad, but soft drinks period are BAD for your kidneys.  So is anything with artificial color (red).  

You mentioned your BP is high.  Has it always been high?  This could be a sign of kidney problems.  I'm not sure if other things would be high too.  I just know my BP has been up there at times.  Normal for me is 90/60.  So 130/95 is really high for me.  But I think dealing w/pain can make it go up too.

My advise to you is to ask your dr. to monitor this situation and hopefully you won't get the run around I've gotten for the last 6 months.

[JohnBates]

BP is now ok.  I put it down to stress.  I went back on my meds that probably caused the problem as per specialist advice.  He thinks that the problem is not a big one and I can wait for now.  My BP went up to 160/110 for a few weeks.  Resting pulse was 100.  I am exercising again now as it was driving me nuts.  I just keep sinking the pain meds and it does not hurt too much.

I feel better in myself for doing the exercise but I get real stabbing pain in the kidney and below regularly when exercising.  I guess it is somthing that I will have to live with.

Are there any vitamines that I can take to help?

John

[karajo]

John,

I'm glad your BP is OK.  I normally have low BP (90/50ish), but since the UPJ obstruction it has been 130/100.  FYI, high BP is a SIGN of UPJ obstr.  

I don't think the med. caused your problem.  Did you ask the dr. what he/she thought?  Generally, ureter obstructions is caused by a conjenital defect, or a floating kidney, or a stone caused scar tissue to form.  There are various causes. They can put in a stent to get you by, but even they have their problems.  

You are much tougher than I, even on my "good days" I would not attempt to excercise.  Just a 5 min. walk lays me out for days.  If you have an intermittent obstruction, you could manage to get by for a while.  The drs. have put me off now for 6 months now.  The hydronephrosis has grown from 2.43 cm to 4 cm. during that 6 months.  

Do a search on this article on your internet:
Intermittent Hydronephrosis Secondary to Ureteropelvic Junction Obstruction: Clinical and Imaging Features
(If you have trouble finding it, let me know and I'll look up the exact web site for you.)
This article might help you make some decisions about your condition.

Those "stabbing pains" in your kidney and "groin"(?) is your kidney screaming for help!!  I can take some pain med and push myself through what I need to do that day, but it wipes me out and I have spasms in my kidneys the next day.  

John, I'm praying for you.
I pray the Lord Jesus show you how much He loves you!

Kara