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Renal cyst


  About 5 years ago I was diagnosed with UPJ obstruction. My doctor
  said my ureter was narrowed at the top and where it enters the
  kidney is too high. He said this was a congentital birth defect.
  I had a endopilotomy and havn't had any problems since except if
  I drink alcohol. I would have pain in the kidney area. So I don't
  drink anymore other than an occasional glass of wine or beer. A
  couple of weeks ago after having a beer I started having pain in
  the kidney area,got so bad I was vomiting and had the chills.
  I went to the hospital and they thought it was kidney stones and
  told me to contact my urologist. They did a sonogram and didn't
  see anything. There was no infection in my urine but there were
  traces of blood. When I went to the urologist he said there was
  a cyst in the lower pole of my left kidney[same side as the UPJ].
  I am scheduled to have a KUB, renal scan and a cystoscope. Do you
  think alcohol had anything to do with it, my Dr. dosn't. Anything
  you could tell me would be helpful, I am pretty scared right now.
  No family history of renal cyst but my father had adrenal gland
  removed because it had tumors in it. Have a cousin that also had
  UPJ obstruction on the left side. Thanks ahead of time.
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Dear Tami,
I think your doctors are giving you the right information.  The alcohol should have nothing to do with the kidney stone or the cyst.  The cyst can be followed conservatively over time and interval ultrasounds can be done if necessary.
A possible  reason that you experience periodic flank pain especially after you drink alcohol, is that the drainage system in your left kidney becomes overwhelmed.  Think of your system on the left are as a partially clogged drain in your kitchen sink.  If your wash a few dishes and use a small amount of water, you will never notice that the sink backs up.  If you wash  a hole bunch of dishes and leave the water running perhaps to clean the sink, you may notice the sink backs up.  In time, the sink will drain, but for a moment it appears that your sink is clogged.  Imagine this same scenario with your kidney.  The normal amount of fluid is able to drain without you having significant problems(pain).  If you add alcohol, which acts as a diuretic, you make more urine at a faster rate which backs up your system, mildly.  You experience some pain, but it goes away after your urine production returns to normal.  If you had a stone, that clogs-up your kidney completely, and you experience the full effect of pressure on the kidney.  In this case the pressure is not relieved until the stone has passed.  Once the stone passed, so did your symptoms.
There are several studies that could be done to see just how well your kidney empties, but they probably will not change your management.  Try to keep yourself on a good drinking regimen but stay away from excess alcohol and other diuretics.(coffee, tea, caffeine)  It sounds like your urologist is on top of the situation, ask him for further treatment options.
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, relative ureteropelvic junctioin obstruction
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