Bladder or kidney problem?

[kaz1]

I have been suffering with mild to moderate lower abdominal pain for approx one year now. Mainly dull aching.
I have had a colonoscopy and gynecological scans, which were fine. Then about 6 weeks ago, I noticed that I had blood in my urine. The doctor sent a sample to the lab and it showed a small amount pus and a large amount of blood. But there was no infection present. Blood tests were all normal. I was then sent for an ultrasound of my urinary tract. It showed my right kidney is enlarged and working hard. I had by this time started to get some discomfort in my right side and lower back. Since then, you can feel a swelling in that area on my side at the bottom of the rib and now the left side has started to hurt too. It also has some swelling there, but not as much as the right side.
I am constantly tired, fell sick and have discomfort in my sides, back and lower abdomen.
The ultrasound did show some granular sized stones, but the health professionals have all said that they are too small to be causing the problem.
I am waiting for an appointment with urology.
Does anyone have an idea what could be wrong with me?
I have found all sorts of things, but nothing fits the symptoms 100%??

[bhattims]

Dr Rajiv

Thank you very much for the above usefull informations. Can you please share molecular weight of hyaluronic acid in urinary bladder wall.

***@****

[Rajiv Goel, MD]

Dear kaz1,

Thank you for writing back.
All your results are within normal limits except the sodium levels. Although the abnormal sodium levels don't provide any clue to the diagnosis but let me assure you that you have normal biochemical function of the kidneys. This means that they are handling the solutes well, a key function of the kidneys.

A higher sodium level is not significant in the present setting. It simply means that you were probably mildly dehydrated while the blood sample was drawn for this test. You should consume 2-3 litres of water daily. This will help reduce the infection by some degree.

Hope that this information helps and hope that you will get better soon.

Best Regards,
Dr. Rajiv Goel

[kaz1]

Hi,

Thank you for your reply.
I have has some blood test results, but am still waiting for my urology appointment.

The blood results were as follows...
Urea- 23.6 mg/dl
Creatine- 1.1 mg/dl
Sodium- 158.5 mmol/l
Potassium- 5.3 mmol/l

I would be interested to know if this would give you any more indication as to what the problem could be?

I look forward to hearing from you soon.

Thanks for your help.

[Rajiv Goel, MD]

Dear kaz1,

Thanks for getting back.

A swollen kidney with hydronephrosis certainly indicates that you have obstruction somewhere in the urinary tract and this is the cause of your symptoms. The exact site cannot be determined without investigating further. A computerised tomography urogram (CT urogram) would definitely help us evaluate the site and cause of obstruction. The obstruction can arise from a stones, strictures, neoplasms and several other conditions.

I would suggest that you get this investigation done in consultation with your treating physician. We can then take this further.

I hope I have answered your query.

Best Regards,
Dr. Rajiv Goel

[kaz1]

All of the tests so far have showed that there is no infection present. The scan did show that it was swollen with hydronephrosis. Do you think then that I have a blockage in the ureter? What would cause that?

[Rajiv Goel, MD]

Dear kaz1,

Thanks for posting your query.

From your description, it appears that you are probably suffering from recurrent pyelonephritis. This refers to a kidney infection, usually from bacteria that have spread from the bladder.

Your right kidney could be swollen due to pyelonephritis or hydronephrosis secondary to obstruction in the ureter. Hydronephrosis is a condition when the kidney swells up as there is an obstruction in the flow of urine.

I would suggest that you go ahead and consult your urologist who can perform an evaluation and order therapy like tamsulosin (which is an alpha blocker) and order investigations like a computerised tomography (CT) urogram which would provide vital clues to your ailment and its treatment.
Till then, I would suggest that you drink plenty of cranberry juice which has been shown to fight urinary tract infections.

I hope I have answered your query.

Thank you for using MedHelp's "Ask an Expert" Service, where we feature some of world's renowned medical experts in their fields. Millions have benefitted from our service to get personalized advice for them and for their loved ones.

Best Regards,
Dr. Rajiv Goel