renal colic after stent removal

[wildrehab]

I had a robotic pyeloplasty done three weeks ago on my left ureter.  The doctor removed the stent two weeks later.  About 12 hours after the removal, I went into renal colic.  The severe pain lasted about 24 hours, and four days later, I still have pain (though manageable) on my left side -- most often in my back, sometimes in front, sometimes both places.  How long should I expect this pain to last?  Is it possible I'm having a complication?

[cbrooks859]

You are right, the 800 Ibuprofen plus a muscle relaxer (I take Soma) is the perfect combination. Much more affective than morphine, hydromorphone, etc.

Last week I had to have emergency surgery due to the right ureter stent getting blocked. My urologized replaced it with a size 8 stent, which should last at least 6 months. He said that once he can identify which part of the ureter is causing the blockage, he can perform a pyloplasty.

Regarding LSU, my husband graduated from their medicial school in 2004. If you like, I can ask him for specific names and contacts.  

[wildrehab]

Thanks for your comment.  I'm sorry you were in horrible pain, too.  Renal colic is not fun.  The only thing that helped me was percocet.  Take care.

[thedeloachs]

Oh man I just had my stent removed Tuesday and can just now walk today which is Saturday. I had Renal Colic as well. NO amount of pain meds helped..however 800 mg Ibuprofen provided the most relief along with zanaflex muscle relaxer. It was severe for about 18 hours then subsided into a dull throbbing ache til today not it's just uncomfortable. I had the stent in for a week due to UPJ obstuction from kidney stones...worst pain of my life.... good luck

[wildrehab]

Thanks for sharing your story.  I had a stent reinserted on Tuesday because my ureter was too swollen to allow urine to pass, resulting in hydronephrosis again.  It will stay in 6 weeks, but I hope and pray it works this time.  They said I could go into renal colic again when they remove it.  But even if I do, I hope the ureter doesn't swell again.

[cbrooks859]

Flank pain is not normal. I experienced this for four years, after a botched kidney stone surgery where my right ureter was damaged. For four years I went to five different urologists who could not help me. The last two years I went to a pain management clinic for intercostal and lumber nerve blocks every 3 weeks. Complete hell. The hydromorphone I was on barely touched the pain.

Finally, I was referred to the attending physician urologist who trained my previous five urologists. He placed an indwelling stent in my right ureter in January 2009 and guess what? After a couple of weeks of healing, no more flank pain and now I only have to take over the counter Tylenol!

So there is hope. Try to find the best, most experienced urologist to help you in placing another stent. Good luck. It is important for you to realize you are not crazy. My current urologist said I am only the second case he has ever had where my right ureter looks normal but will not work correctly unless a stent is present.

[got_my_life_back]

I don't have any of my scans either, sorry! LSU sounds like a great idea, I truly believe you'll find someone who is interested in taking care of you. Besides, learning hospitals thrive on patients like us that no one else can figure out or cares to figure out. I wish you the best. And the radiologist lied to you, just because the dye passed clear through does not make your scan normal. All that shows is that the tract is open and YES you do have a stricture at the base of your kidney-if that were your heart you'd have a stent right now!!!! (The docs at UC did place a stent before I had my nephropexy just to see if opening that area up more helped.) Keep us posted on your progress:)

[Jackytheripper]

Hey I’m jack I had a robotic pyloplasty completed one year ago and I’m in chronic pain in my flank. I no longer can even sit in a chair due to so much pain. The supposedly did a nephropexy during my surgery but obviously not enough. I have burning pain down my back and sometimes a painful dull pain. It’s been hard to live with two young kids and having a job. Did the nephropexy fix you?

[Sara_MHModerator]

Jackytheripper, thanks for sharing your story.  We are sorry to hear you are in so much pain.  Is your doctor trying to help you?  Parenting is hard enough let alone when you are in pain! I am sure this is very frustrating. And unfortunately, long term flank pain is something many report after robotic pyloplasty.  Here is a study of others in your situation. https://www.researchgate.net/publication/8653006_Long_term_results_of_pyeloplasty_in_adults
We do have a chronic pain forum called pain management where you can connect with others.

[wildrehab]

I do not have any of my scans.  Sorry!

I think it's a wise decision to see someone at LSU.  Good luck, Karajo!

[karajo]

Hey girls,
Thank you so much for all of your help.  I know wildrehab was needing help herself, but ended up helping  me instead.  I don't have the intense spasms unless I drink a lot of water.  So I stopped drinking so much.  And it seems like the more urine I have (like in the mornings) the weaker the stream.  

It still amazes me that wildrehab didn't have any symptoms at all.  The doctor that did the retro renogram said that it was normal.  So I asked him if the pinched off area was normal and he said that the dye went all the way through and that it was functioning.  Therefore it was "normal".  My family dr. is the only dr. who has pointed specific things out about that picture.  He said that in hydronephrosis the glomer things will round out and mine are still pointy.  But I know that picture was made over a year ago.  I think I might try a doctor @ LSU med center. That is a learning hospital about 2 hours away.  I honestly have lost all confidence in urologist.   Not sure really what I should do.  

Do either of you have any scans from your test that you could compare the Renogram or IVP with?  

[got_my_life_back]

I did have frequent UTIs and kidney infections, but also alot of stones related to my kidney not draining well. Spasms and renal colic aren't any fun either, when they hit-it's relentless and there is nothing you can do to make it stop. I had weak stream, frequent stream and painful streams-sometimes all at the same time. My surgeon had to laugh at me, I intentionally wouldn't drink alot just to minimize my symptoms! I truly hope that you find a surgeon who will help you. It begins to wear on your mind when you feel bad more than you feel good. I'll be praying for you.

[wildrehab]

I have never had a UTI or kidney infection.  I have had spasms like you mentioned for years in my right (healthy) kidney, although they are very infrequent and I've never even mentioned them to the doctor.  I'll get one or two and then won't feel it again for weeks.  I can't imagine getting as many as you've had -- they are painful!

The ureter spasms (renal colic like I had last weekend) are unbearable as well, but constant and it's impossible to get comfortable.  According to many doctor's articles online (just goggle "renal colic") it is the most severe pain humans ever experience.  I pray you never experience that!

I did see the pic of your kitty kidney -- WOW!!  That is amazing -- and cute!.  Are the urologists amazed by it, or not?  Is the kidney enlarged at all?  That is what damaged mine, having it swell and stretch.  The tissue became thin and irrepairable, so even though they hope it will function again, it will never function completely.  So if yours is enlarged, I'd be concerned and asking for them to do a robotic pyeloplasty like I had.  FYI, the robot that was used is called Da Vinci.  You can find that online as well.

Have a great Sunday!

[karajo]

I so appreciate you and wildrehab answering all of my questions.

A few more:
Did you have frequent UTI or kidney infections
Was your stream weak. (I know you said it was in small amounts)

The kidney spasms that I have occasionally are like a stabbing, take your breath pain.  It's quick and spasmy feeling.  When this happens it happens repeatedly for hours.  They just wear me out.  I usually have to take something for pain and just get somewhere where I can lay down and get real still.  (Does this sound like the spasms you were having?

My last diurectic renogram said:
T1/2 pre lasix LT 33min
T1/2 pre lasix RT 19min
T1/2 lasix LT 45min
T1/2 lasix RT 36min

[got_my_life_back]

My symptoms varied over time, but the flank pain was near constant. For awhile the doc put me on Detrol thinking that I wasn't emptying my bladder. I seemed to always need to urinate but it was frequent small amounts. However, my bladder scans always showed an empty bladder. As time progressed, I began having nausea more often than not, general malaise and fatigue (spasms, heart palpitations and a host of other nondesirable symptoms when my nephroptosis was at its worst!).  Unfortunately, your conditions all can mimic different systems and it can be difficult to differentiate which one is causing your issues. If your Lupus is well controlled, you can rule out that as the cause. Fibromyalgia is somewhat of a blanket diagnosis, there is no definitive test to diagnose it and it seems to be the label when the doctor can't necessarily find something else wrong. Hopefully you have a good doc who is willing to listen and together you can get to the bottom of your  problem. Good luck on your quest:)

[karajo]

what exactly were your symptoms?

Did you have a weak urinal stream and flank pain along with spasm in your kidney?

I'm trying to figure out which symptoms are lupus, fibromyalgia and which ones are hydronephrosis.

[got_my_life_back]

Initially I was diagnosed with a UPJ obstruction. I had 5 years of tests that every doctor accounted to kidney stones until a lasix renal scan showed decreased function on my right side. My second surgery was due to nephroptosis (falling kidney), which the surgeon said had been a problem all along but having the pyeloplasty bought me a little time with lessened pain. Going to a larger/teaching hospital the physicians and professors all had a different background and were able to pool their ideas in an effort to help me. I can't begin to tell you how improved my life has been since my second surgery. Good luck!

[karajo]

What ended up being the problem after the surgery?  

[got_my_life_back]

You definitely have issues that should raise concerns with a urologist! It might be inconvienent (sp?) but ask to be sent to a larger medical center/learning hospital. I complained for YEARS to the same urologists who had already performed an open pyeloplasty that something was wrong and got brushed off. Luckily, I had a wonderful nephrologist that sent me to a University Medical Center (90 miles one way) where they were more than willing to find and fix the problem. You know your body better than any doctor could dream of, be persistent and relief will come!

[karajo]

So GLAD  to hear from you!!!  Hydronephrosis is so very rare and to find someone to talk to is a blessing to me.  Did you have any kidney infections or just felt bad...ANYTHING!

I have actually seen 5 (FIVE) urologist.  ALL have dismissed me and some have actually told me that nothing is wrong with my kidney.  They have told me it's just the way my kidney is made.  So I told them, then that would be the way it was 3 years ago when I had a kidney stone in the other kidney.  They refuse to compare the two CTs to confirm  or discount their thoughts.  They say things like it doesn't look that bad, and I told them,"that's because it's not in your body."  I was having severe flank pain and nausea.  I now know that the nausea was caused by lupus.  But I'm not convenced(sp?) that the lupus is causing the flank pain and spasms.  I still occasionally have that.  And I don't know if the lupus is causing the very weak stream of urine and the occasional infection and protein in my urine.  My family doctor has sent me to several drs  because he keeps telling me there is definitely something wrong with my urinary tract.  The gynecologist sent me to another one.  And the gastrointerologist sent me another one.  That is why I've been to so many.  They keep thinking that someone will see what theya re seeing.  By this point, most of the urologist are just more concerned with what the other urologist are saying.  I agree that it might be considered mild, but I don't agree that there is nothing wrong.  

I'm going to try to put a picture of the retrograde pylogram up on my medhelp site.  If I am unable to do it, just send me a personal note with your e-mail and I can e-mail it to you.  My kidney looks like a cat and you can plainly see the stricter in the ureter.  It "looks" like it is completely pinched off, but obviously it functions because the dye got from point A to B.  I guess they are going to wait until it is NOT functioning.  But what they don't know is if I loose that right kidney, they are ALL getting sued.  I am a Christian and don't believe in that, but this has been ridiculous.  They found the hydronephrosis on a CT a year and a half ago.  The last IVP was done last Sept and it took 45 min for the dye to finally get to the bladder in comparrison to 15-20 min a year ago.  It flows but just not very rapid.  Normal is 2-5 min.  

[wildrehab]

I really didn't have any symptoms that I was aware of.  I had severe hydronephrosis and a blockage at the top of my ureter which were discovered first during an ultrasound that was done for another reason.  After seeing the enlarged kidney, they did a CT scan.  Prior to surgery I had a renogram (to determine if my kidney was functioning at all -- it wasn't) and pyelogram (to help them see where the blockage was).

I won't know exactly how successful the surgery was until I have a follow-up CT scan in two more weeks, but the doctor felt the surgery went well.  As far as how I faired, it was a two-day hospital stay and I was on morphine, then percocet which kept my pain away (but made me groggy and eventually ill -- my gi system does not like percocet).  The  renal colic I had after the stent was removed was horrible, but is not normal for most people, so if you have a stent, don't worry about that happening to you.  Also, the removal of it is no big deal.  It only takes a couple minutes in the doctor's office and is not bad at all -- you just feel a little pinch.

It sounds to me like perhaps you should get a second opinion.  Are they expecting your blockage to clear itself?  What tests have you had?  I would think they would want to take care of it b/c the longer your kidney is enlarged, the more damaged the tissue becomes.  Mine is quite damaged and will never go back to it's normal size and shape, and it will never function at 100%.

Thank you for your sweet concern!

[karajo]

I can't answer your question, but would be interested in how you faired with the surgery and what exactly happened to your ureter to warrant surgery.  

I have a pinched off area in my right uretopelvic junction and have hydronephrosis.  I can't even get them to put a stent in to see if it would help with my symptoms.  I have a very weak stream...extremely weak.  And occasional flank pain and sometimes spasms in the flank area.

What was your symptoms prior to surgery.

I'm so sorry to hear that you have been having problems.  Is the pain you are having now worse than the pain before the surgery?  Can it compare to what was going on before?

Praying for you