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Suggest Treatment For Cyst In Kidney

Posted on Fri, 21 Aug 2015

Question: My father's has cyst in kidney measuring 28*25 mm in lower part. What is solution for it? He has undergone prostrate surgery for more than 4 days he is keep on getting clots in bladder. I would like to know what is reason for it. What is solution for it. How to solve it. He has been hospitalized more than 15 days but no improvement in health.

Answered by Dr. P. T. Patil (34 minutes later)

Brief Answer:
Bleeding is from residual prostate and rough surface from resected area.

Detailed Answer:
Hello
Thanks for query.
Your father has undergone surgery of TURP for enlarged prostate 4 days back and now having bleeding (Blood clots in bladder).

It is common to have bleeding from raw surface from where prostate is resected and normally it gets resolved within 3-4 days.

Looking at the ultrasound finding of residual prostate of the volume of 38 cc it is likely that he is bleeding from this residual prostate too.

Please keep him under observation of Urologist and you can expect bleeding to stop spontaneously.with antibiotics ,.continuous irrigation with saline which may take 3-4 more days .If necessary he may require to undergo small procedure of evacuation of clots from bladder.

Once the things are settled and if he still persists to have obstructive voiding urinary symptoms he may need to undergo second sitting of TURP to resect residual prostate.

Hope I have answered your query. If you have any more questions please feel free to ask me I shall be happy to help you .
Thanks and Regards.
Dr.Patil.

.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. P. T. Patil (9 minutes later)

Second set prostrate surgery also done. Now is it seems to third surgery? How about cyst?Is it risky

Answered by Dr. P. T. Patil (25 minutes later)

Brief Answer:
Please provide details of surgeries done so far

Detailed Answer:
.Hello
Thanks for follow up.
You have not mentioned about second surgery in your query posted earlier.

Please provide details whether scanning and the report that you have posted was done after first surgery or second surgery.

If he has residual prostate of 38 cc even after going through second surgery and he still persists to have obstructive voiding symptoms there is no option but to go for surgery.

As regards cyst in the kidney .It is benign cyst mostly from the birth and do not need any treatment .

Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. P. T. Patil (1 hour later)

Hello Dr,

Sorry for missing information.

First there was a surgery for prostrate enlarge. Later there was health issues started such as vomiting, fever, and problem in urination.We admitted him in hospital than later scan was done in that it was there was a clot and Dr did a procedure and removed it but there was no improvement. Again there was a scan and later they did a prostrate surgery. Today they did another scan where it is showing clot. I am not understanding why this happening repeatedly. what is best solution for it. In a month 3 times surgery being done and not solving the problem. Can you suggest is there any surgery failed issues. He is saying he is feeling weak and his sodium level also getting down. Can you please suggest what needs to be done.

Answered by Dr. P. T. Patil (2 hours later)

Brief Answer:
It seems that Evacuation of blood dlots done twice after first surgery

Detailed Answer:
Hello
Thanks for follow up and uploading reports .

To summarize I would recapitulate
He was operated for TURP and developed retention of urine due to blood clots which was evacuated endoscopically on 12 XXXXXXX

He again had bleeding and had blood clots and the clots were evacuated again on 17 th XXXXXXX

His recent ultrasound scan reveals residual prostate of size of 35 cc.
The surgeries done twice after first surgery were done to remove the blood clot and not for removing (Resecting ) the residual prostate .His recent scan still reveals residual prostate of size of 35 cc If he still has obstructing voiding symptoms it may need to be resected at later date once his present condition is stabilized.

These are known complications of TURP surgery that we urologist face once in a while.

Do not worry your father will recover fully within one month time .
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. P. T. Patil (2 days later)

Hello Dr,

There is another surgery being done to take out clots. After the surgery urine color was white. When he turns it comes red in color ans after some times it gets clear. Some times with clots urine comes and with red color. what is your thought on this? Is there any bleeding happening internally. His sodium level was today 126. What we should do improve soon his sodium level.

Answered by Dr. P. T. Patil (16 hours later)

Brief Answer:
Give Sodamint tablets to increase sodium levels.

Detailed Answer:
Hello
Thanks for follow up.
The recurrent bleeding that he is getting is from the raw area created by resecting prostate tissue and will gradually stop as healing progresses.which some times takes 3 weeks ,

What you have to ensure is that he drinks more water .

Continue taking antibiotics and Soda-mint tablets to increase his sodium levels.
Thanks and Regards.

Have a patience your father will fully recover and will resume normal activities .
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Shanthi.E

Follow up: Dr. P. T. Patil (7 days later)

Hi Dr,

Your answer's were very helpful. I have uploaded some more reports.He has undergone for blood clot removal. He got discharge from hospital. I am aware that
he has some urine infection for that 5 days antibiotics which has been stopped now.
What precaution we should take at home?

Please advise me on his urine infection condition and his progress.

Answered by Dr. P. T. Patil (27 minutes later)

Brief Answer:
You can continue Inj Amikacin twice daily for another 5 days

Detailed Answer:
Hello
Thanks for uploading reports .The routine urine and culture test reveals infection and the antibiotic sensitivity to Amikacin .

Continue taking Amikacin for 5 mare days.and Vit B complex .

Ensure he drinks more water .

He will be normal gradually over next 2 weeks .

Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. P. T. Patil (1 hour later)

Thanks for information. Is there any chance of getting back clots?

Answered by Dr. P. T. Patil (9 hours later)

Brief Answer:
No there are no chances of clots getting again.

Detailed Answer:
Hello
Thanks for follow up.
Since 3 weeks have already over after surgery there are no chances of him getting clots again.

Just ensure he drinks more water,

Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. P. T. Patil (4 hours later)

Is it required to control his diet? What kind of food he should eat and type of food he should avoid?

Answered by Dr. P. T. Patil (20 hours later)

Brief Answer:
Let him have food of his choice

Detailed Answer:
Hello
Thanks for follow up.
here is no restriction on diet ,let him have food of his choice .
Ensure that he drinks more water.

Include fruits and spouted cereals so as to keep stool soft and he does not get constipated .

You may give him mild laxative like Cremaffin at night so that he does not have to strain while passing stool.

Give some vitamin supplements and proteins like Bournvita with milk.

Do not worry he definitely will not have bleeding again of which you are scared about.

Trust in nature equal to Doctors that helps to relieve most of the health issues.

Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. P. T. Patil (10 days later)

Hello Sir,

I am back with my queries.
My father was under medication with Pause-500 and Punox. After we stopped he is getting very mid level of blood in urine from past 3 days. Can you suggest what needs to be done. Is it something serious?What could be reason for this to happened?

Answered by Dr. P. T. Patil (20 minutes later)

Brief Answer:
It is normal to have slight bleeding after 3 weeks of surgery.

Detailed Answer:
Hello
Thanks for follow up.
During healing of a raw area created by removing prostate scab is formed as a protective covering over the resected surface.This scab starts getting shade off between 3-4 weeks after surgery by which time healing has took place .The shading off of this scab causes slight bleeding from the surface .

There is nothing to be worried about .

Ensure he drinks more water and take mild antibiotics like Norfloxacin twice daily fr a week.

Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. P. T. Patil (20 minutes later)

Can you please suggest me how many days he should take rest. What are the precaution we need to maintain. Is it travel suggested for him? If not how many months he should not travel for long distance?

Answered by Dr. P. T. Patil (4 hours later)

Brief Answer:
There is harm in travelling .

Detailed Answer:
Hello
Thanks for follow up.
Since it is one month after surgery there is no harm in travelling in train for a long distance .

He should take est till he feels comfortable and gradually increase his physical activities.

Please observe hat he does not get constipation hence give stool softener like Cremaffin at bed time .

Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. P. T. Patil (2 hours later)

Hello Sir,

I have question. He is complaining urine is licking. Why it should happen suddenly. What could be reason for it. What needs to be done?

Answered by Dr. P. T. Patil (25 minutes later)

Brief Answer:
urine leakage is doe to mild infection

Detailed Answer:
Hello
Thanks for query.

Urine leakage is mostly due to mild infection and inflammation of prostatic fossa .

Get his routine urine test done and take antibiotics suggested in my reply earlier.

Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. P. T. Patil (4 days later)

Hello Sir,

I have attached new urine culture report. Please help me to understand. Couple of weeks back we did his urine culture and it came no significant results found. But when today we are getting with infection. What is that mean? Is it a recurring process? He is still having urine leakage after the medication. After the medication start he is having his urine in-completion. Why such kind of complication could raise sir? Is there any problem? For leakage is there again surgery required? I am worried for his health? Please suggest me.

Answered by Dr. P. T. Patil (1 hour later)

Brief Answer:
Read detail answer below.

Detailed Answer:
Hello
Thanks for writing again.
I know the detail history of your father and the complications he has gone through after TURP surgery.

I shall be happy if you can provide me few more details to make precise comments
1) Can he hold on his urine or there is constant leakage of urine ( Incontinence of Urine) ?
2) Does he have normal urine flow and there is intermittent leakage of small amount of urine ?
3) Does he have urgency?

There are three known landmarks after the surgery of TURP . These are 3 days ,3 weeks and 3 months
1) 3 Days -When there are high chances of bleeding
2) 3 weeks -When there is possibility of bleeding (Hematuria) due to separation of scab formed over resected area of prostate .
3) 3 months -There is always recurrent infection .

Urine culture report done very recently suggests that he has UTI due to E-Coli organisms sensitive to Norfloxacin .This may be perhaps is the cause of leakage of urine

Please give him Norfloxacin twice daily for 2 more weeks .This will help to control infection.

Ask him to perform perineal exercises (Kegel Exercises) .This exercise will help him to strengthen his urethral sphincter which will help to regain control of urination and gradually resolve the problem of leakage of urine .You can surf on internet how to do Kegel Exerccises.

I can understand your anxiety and concerns for your father but I can assure you that he will be normal within few weeks to come .

Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. P. T. Patil (10 minutes later)

Thank you for understanding my concern.

Ans on the below question:

1) Can he hold on his urine or there is constant leakage of urine ( Incontinence of
Urine) ?

Leakage is not constant . It is few times a day. He is able to hold urine

2) Does he have normal urine flow and there is intermittent leakage of small amount of urine ?

Small amount of urine flow.

3) Does he have urgency?

He feel the urgency periodically but not always.

He is taking now Levoflox 500 Mg. Still we should give him Norfloxacin?

I heard generally surgery being done for leaking? Is there possibility of this also?

What we should do to avoid these recurrent infection

Answered by Dr. P. T. Patil (11 minutes later)

Brief Answer:
He does not require any surgery for leakage of urine.

Detailed Answer:
Hello
Thanks for feedback .

The leakage he has is due to infection which will get resolved with antibiotics .

There is no need to take Norfloxacin in addition to Levofloxacin

Surgery is advised when patient has no control over urination and he is unable to hold on urine suggesting damage of the urethral sphincter during surgery.This is ruled out in your father's case .

Ensure he drinks more water .Have a patience Believe in nature and God .Time is a great healer.

Thanks and regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. P. T. Patil (11 days later)

Hello Sir,

Today we have done my father's urine test.His pus cell level is 18-19. What needs to be done. He is under medication from time. What could be reason for not reducing his infection? What needs to be done?

Answered by Dr. P. T. Patil (7 minutes later)

Brief Answer:
In absence of symptoms presence of pus cells indicate inflammation .

Detailed Answer:
Hello
Thanks for follow up.
In absence of any urinary symptoms like frequency,burning urination suggests inflammation of the prostatic urethra which remains up to 3 months .and there is nothing to be worried about it .

Give him prophylactic antibiotic like Nitrofuarantoin once daily .

Ensure he drinks more water,

Thanks and Regards.
Dr.Patil.

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Above answer was peer-reviewed by : Dr. Shanthi.E