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Hydronephrosis, removal of the kidney stent , hyper plastic polyps - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Very Good Posted in: Kidney Conditions
Answered by

General & Family Physician
Practicing since : 2009
Answered : 594 Questions
Doctor :   Hi
Doctor :   sure , please proceed
User :   what non invasive procedure can be done for removal of a remnant stent
User :   inside the kidney
Doctor :   may i know for whom is this?
User :   me
Doctor :   may i know your age /
Doctor :   and gender
User :   when the doctor removed my double j stent the end inside the kidney broke
User :   28 female
User :   i have been through so many surgeries already and i think i dont need another one
Doctor :   ok
Doctor :   may i know when the stent was placed ?
User :   last year
Doctor :   can you elaborate on the details , why was this indicated , your symptoms and why is it suggested for removal now?
User :   it was placed because of kidney stones in the right kidney
User :   because my right kidney when i had ultrasound that it was hydronephrosis
Doctor :   ok
User :   so when they checked they have seen that my right uereter was damage in my gynecologic surgery
Doctor :   ok
User :   so the ureter was so smalll that the urine back flows
Doctor :   ok
User :   the doctor told me for the urine to pass i need to undergo ESWL
User :   but they need to put a stent so that it will be stretch again and wen the stone pass through after ES#WL it would be easy
Doctor :   yes
Doctor :   that is true
Doctor :   please continue
Doctor :   are you with me ?
User :   the stent was was on feb. 2,2010
Doctor :   ok
User :   sorry i just went to get my record
Doctor :   no problem
Doctor :   please proceed
Doctor :   have they advised for the removal now?
User :   for i while doctor im just looking for the dates
Doctor :   what procedure has your doctor suggested for you?
User :   open surgery
Doctor :   ok
Doctor :   did they consider endoscopic removal as an option?
Doctor :   i would like to know why are they opting for an open surgery ? did they specify any reason ?
User :   thats is why i am looking for a 2nd opinion because they are not telling me i open surgery in needed
User :   doctor i would like to give you more details just give me a few seconds to gather all information
Doctor :   sure
Doctor :   i will wait
Doctor :   take your time
User :   doctor i would like to correct the dates
Doctor :   ok
User :   place insertion was done june 12, 2010
Doctor :   ok
User :   ESWL was
User :   aug.17
User :   sept. 29
Doctor :   ok
User :   and december 7 2010
Doctor :   ok
User :   the stent was removed on february02,2011
Doctor :   what was the procedure done when the doctor tried removing the stent first time? was it an out patient one? or endoscopy?
User :   when they were removing the dr. told us that the end of the double J stent inside the right kidney broke
User :   in patient
User :   yes endoscopy
Doctor :   under local anesthesia?
Doctor :   ok
Doctor :   it is unfortunate that the stent broke
Doctor :   and could not be removed completely
User :   yes it was under anesthesia
Doctor :   may i know presently what are the symptoms you have? do you still have urinary symptoms?
User :   the anesthesia using a oxygen nasal cannula
Doctor :   may i just know the names of all the surgeries you have undergone so far ?
User :   apppendectomy
User :   3 times C/S section
User :   subtotal abdominal hysterectomy
Doctor :   ok
User :   left salphingo-oophorectomy
Doctor :   ok
User :   laparoscopic cholilecystectomy
Doctor :   ok
Doctor :   any other procedures?
User :   placement of stent, ESWL & physical therapy for my spine
Doctor :   ok
Doctor :   let me explain it to you
User :   oh just trhis month i undergone 2 colonoscopy
Doctor :   ok
Doctor :   i understand that you have gone through a lot of it
Doctor :   i really appreciate that you have put up with so many surgeries being a young woman that too
Doctor :   generally stents are easily removed with anesthesia through endoscopy
Doctor :   this would cause less discomfort and lesser complications
User :   what do you think was the cause of that brokem
Doctor :   but in your case , as the stent broke , which is very unfortunate, we need to be very cautious when we do a revision procedure
Doctor :   we cannot ascertain the cause
Doctor :   it could bean unexpected accident
User :   he said that because the stent was inside me for too long
Doctor :   which neither the doctor nor the patient can be blamed on
Doctor :   yes , that could also be a possibility
User :   he is blaming me
Doctor :   any procedure has risks and complications
Doctor :   we must be ready to accept them
User :   but he was doing eswl so how come that i was the caused of it
Doctor :   and every procedure is done in view of the patient's good
Doctor :   do not think much on what he is saying
Doctor :   forget it
Doctor :   let us think what next to be done
User :   and after telling me that is broke he wnts me to undergo open surgery
Doctor :   you need to be healthy , safe and away from any complications
Doctor :   since it has been given a try once through endoscopy
User :   i need to pay 0000 pesos thats $5800
Doctor :   you have been advised for an open surgery
Doctor :   as endoscopy can again fail
Doctor :   i understand
Doctor :   so , open surgery will reduce any further risks or complications
Doctor :   it will make sure that the broken stent is removed
Doctor :   if they attempt endoscopy again , it would be technically difficult and again results cannt be predicted
User :   and i tried asking another urologist of how much can an open surgery domne he told me $1500 only
Doctor :   ok
Doctor :   i suggest you take another opinion
Doctor :   consider visiting another good doctor
Doctor :   with all your reports
User :   so theres no non invasive surgery that can be done
Doctor :   and explain your concern
Doctor :   endoscopy is ideally done
User :   one doctor told me of rigid or flexi scope
Doctor :   but if it has already been attempted , only surgery is an option
Doctor :   yes , that is also an option
Doctor :   but i may not be very sure how well it would show results on you
User :   how is it done
Doctor :   take an opinion again
Doctor :   it is also done like endoscopy
Doctor :   but as i said the results will vary
User :   what about percutaneus nephrolithotomy
Doctor :   that will be a simple procedure again but sucess rates re again a question
Doctor :   these are all first time options
Doctor :   considering your history , since the stent is broken now , it would be technically very tough
User :   ok so if i want a super sure way it is open surgery?
Doctor :   yes , exactly
Doctor :   that would be convincing and would not leave any doubts
User :   i dont know if i mention that all of the lower portion of the stent is still intake only that end inside the kidney was cut
Doctor :   ok
User :   they have remove the stent whole
User :   only the one with a loop in the end
User :   was remain
Doctor :   since the doctor has said that it has broken , the left over piece must be removed as it cana ct as a foreign body
Doctor :   may cause obstruction or infections
User :   no i was just the one who used the word brocken
Doctor :   why has the doctor suggested open surgery then ?
User :   i dont know in english or in medical terms what to call it
Doctor :   i think you must get back to your doctor and discuss it correctly
User :   i may not have explained to you doctor very well
Doctor :   you can ask him why is he recommending this procedure for you
Doctor :   do not worry
Doctor :   i am able to understand what you have been telling me
Doctor :   please follow my suggestions
User :   isnt it the double j stent when place both their ends have loops
Doctor :   first thing is to consult the same doctor again
Doctor :   yes
Doctor :   if they have already removed, why is a recommendation for a revision surgery
User :   i talked to him a few times alreAdy and is insisting of open surgery
Doctor :   when a doctor insists for a procedure, the patient can ask all questions
User :   because the other end of that stent was left behind while puklling it out
Doctor :   as to why do you need it , what are the reasons , are there other methods and risks ,e tc
Doctor :   ok
Doctor :   it is the same thing as you explained
Doctor :   hence it comes down to the same indication now
User :   yes but doctors here get irritated when patients ask too many questions
Doctor :   as he has suggested it would be an open surgery
Doctor :   i understand , but no harm in asking questions
User :   ok if i would have open surgery can you tell me the risks and complications
Doctor :   sure
Doctor :   risks would be same as any other surgeryunder general anesthesia
Doctor :   1. bleeding
Doctor :   2. infections
User :   what can be also the complications if i do not let them remove this stent
Doctor :   adhesions
Doctor :   4. post operative pain
Doctor :   5.fever
Doctor :   would all be the complications
Doctor :   if you do not let them remove the stent , there will be complications like increase chances of infection
Doctor :   also the stent may cause obstruction
Doctor :   and interfere with the normal systemic functions
Doctor :   it may lead to frequent flare ups of fever
Doctor :   pain can be a constant problem
User :   if open surgery was done will it not cause the kidney to malfunction?
Doctor :   and there are possibilities that hydronephrosis can re occur
Doctor :   no , it will not cause any malfunction of kidney as such
User :   my latest ultrasound says moderate hydronephrosis
Doctor :   ok
Doctor :   are you on any antibiotics?
User :   no
Doctor :   OK
Doctor :   at present what symptoms do you have ?
User :   extreme fatigue
Doctor :   ok
User :   dizziness
Doctor :   ok
User :   i feel like i would have a high fever that my eyes burn but when i check my temp its 35
Doctor :   ok
User :   and my upper abdomen sudden sharp pain that is the reason of the 2 colonoscopy
User :   dr. another thing if you dont mind
Doctor :   please proceed
User :   i would like you to interpret my 2 biopsy
Doctor :   ok
User :   1st sigmoid biopsy
Doctor :   ok
User :   benign colonic mucusa w/ increased eosonophils and some neutrophils in the lamina propria
Doctor :   ok
User :   report on flexible sigmoidscopy
Doctor :   ok
Doctor :   the above report is normal with a mild inflammation
Doctor :   please proceed with the next
User :   there were some folds in the rectum which seemed to be edematous however, there were no ulcers nor erosions noted
Doctor :   ok
Doctor :   that is good to know
User :   the mucosal pits in the rectosigmoid junction were prominent but no disruptions.
Doctor :   ok
Doctor :   what is the final biopsy impression , could you write it for me here ?
User :   a solitary sessile polyp was noted at the 15cm level which was removed using cold biopsy forcep
Doctor :   ok
User :   diagnosis colonic polyp, sigmoid
Doctor :   ok
Doctor :   so do not worry
Doctor :   it is good that it has come to doctor's notice and has been removed
Doctor :   this will reduce your symptoms
Doctor :   have they asked for a review again ?
User :   2 colonoscopy was done in different hosp. so his is the biopsy repot that take a 2nd check of the slides
User :   pathologic diagnosis: User :   mild active colitis
User :   then the report where the polyp was remove
Doctor :   ok
User :   pathologic diagbnosis
User :   hyperplastic polyp
Doctor :   ok
User :   benign mucosal fragments w/ lymphoid nodule
User :   what does all of this means
Doctor :   ok
Doctor :   hyperplastic polyps are of not much worry
Doctor :   they cause symptoms
Doctor :   but rarely they complicate
Doctor :   and the benign mucosal fragments also is nothing to worry about
Doctor :   since you have got the removal done , you must just stop worrying
User :   because we were thinking of ulcerative colitis because of the extreme fatigue and out of nowhere i had athritis in my hands
Doctor :   ok
Doctor :   polyps do cause weakness and similar symptoms
Doctor :   good that you have got it treated
User :   oh
User :   ok dr. thank you very much for your time
Doctor :   pleasure here
Doctor :   please consider a second opinion
User :   yes i would
Doctor :   on your stent and open surgery
Doctor :   i wish you all the good health
User :   definitely
User :   thank you yours also
Doctor :   and i hope you get well soon and do not need any more surgeries
User :   i hope so too
Doctor :   ok
User :   ;)
Doctor :   thanks for consulting me
Doctor :   take care
Doctor :   Bye for now
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