extrinsic defect on left kidney collecting system

[seabeedeb]

I had 2 UAs with trace RBC, so an IVP was done. The report Impression states:

"Duplicated left collecting system and partially duplicated left ureter. In the upper pole collecting system, there is a fixed smooth indentation that may represent extrinsic compression such as a vascular compression, or less likely, an intraluminal filling defect. Recommend further evaluation of the kidneys with a dedicated renal CT scan.

THIS IS A YELLOW DOT CASE FOR WHAT APPEARS TO BE AN EXTRINSIC DEFECT ON THE UPPER POLE MOIETY OF THE DUPLICATED COLLECTING SYSTEM OF THE LEFT KIDNEY."

I saw a urologist last week, and a cystourethroscopy showed a normal bladder and urethra. I also have two urethra openings, one of which is false apparently. I've had a whitish, sticky discharge from my urethra for some time, but the urologist said it wasn't related because my urethra is normal. He thought the discharge might be coming from the false second opening, and recommended seeing my gynecologist.

I was wondering if this indentation could indicate something malignant, would it be possible to just remove the upper pole of the duplicate collecting system since I have a backup one?  The x-ray tech showed me the film, and the two poles were very close to the same size and length, ending in a V shape to a single pole.

Thanks much for any explanation of these findings you can offer.

Deb

[Ash Tewari, MD, M.Ch.]

From what you describe, the lesion seems consistent with a vascular impression from a blood vessel. rarely other intraluminal lesions can also cause a smooth filling defect.

You have not mentioned what the CT showed- was it done at all? If the impression is found to be due to a vessel, unless there is evidence of obstruction, surgery is not required

[seabeedeb]

Thanks for the quick reply!  I'm supposed to schedule the CT scan next week.  Is there any chance this could be something malignant?  I thought lesions were usually something bad.  Thanks again.