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Suggest Treatment For Lumbar Spondylosis And Severe Left-sided Hip Pain
Question: I have been having abdominal pains on the left side of my stomach for over two weeks. It started with a severe back pain which made it impossible for me to stand up. I saw the doctor and complained. The following scans were done: Ultrasound scan and urine analysis. The ultrasound showed that my left kidney is slightly enalrged but that other organs were okay. The urine test showed no sign of any infection. I was asked to use TAVANIC antibiotic for 5 days. When the back pain persisted, i had to do a MRI scan which showed that i have lumbar spondylysis...i was asked to take TRAMADOL AND a NSAID Flotac...these eased the pains and i could walk about uprightly. Few days later, i noticed that the pain was now saturated on my left side...close to the left hip/waist.
I went back to the doctor and i was asked to do a SERUM CREATININE test and a CT scan of the pelvis/abdomen. The creatinine gave a reading of 79.9um/L (normal range is 74-110um/L). The CT scan showed that i have a Left Bosniak 2 Renal cyst (dimension 23*28mm).
The Consultant Urologist has recommended a surgery but i want a second/expert opinion. He said though the cyst is simple but the fact that the pain persists shows it is MALIGNANT. Kindly advise
I went back to the doctor and i was asked to do a SERUM CREATININE test and a CT scan of the pelvis/abdomen. The creatinine gave a reading of 79.9um/L (normal range is 74-110um/L). The CT scan showed that i have a Left Bosniak 2 Renal cyst (dimension 23*28mm).
The Consultant Urologist has recommended a surgery but i want a second/expert opinion. He said though the cyst is simple but the fact that the pain persists shows it is MALIGNANT. Kindly advise
Brief Answer:
CT scan can only suggest possibility of malignancy.
Detailed Answer:
Hello XXXX and welcome to HCM.
As an Urologist, i can fully understand and share your concern.
If your pain is due to the kidney cyst,the pain will disappear after the surgery.
Nowadays,the surgery is done by laporoscopy, and patient is discharged next day.
The biopsy of the cyst only, can confirm the type of cyst, after the surgery.
The CT scan can't confirm, but only suggest,possibility of a malignancy.
If you don't opt for surgery,the pain may be recurrent and cyst will increase in size. It may be advisable to clear it, by undergoing surgery and get it biopsied.
You're welcome to clear any more doubts, you may have.
Wish you a very speedy recovery.
CT scan can only suggest possibility of malignancy.
Detailed Answer:
Hello XXXX and welcome to HCM.
As an Urologist, i can fully understand and share your concern.
If your pain is due to the kidney cyst,the pain will disappear after the surgery.
Nowadays,the surgery is done by laporoscopy, and patient is discharged next day.
The biopsy of the cyst only, can confirm the type of cyst, after the surgery.
The CT scan can't confirm, but only suggest,possibility of a malignancy.
If you don't opt for surgery,the pain may be recurrent and cyst will increase in size. It may be advisable to clear it, by undergoing surgery and get it biopsied.
You're welcome to clear any more doubts, you may have.
Wish you a very speedy recovery.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks Dr. XXXXXXX for your detailed response. What the doctor said what that he was suggesting or recommending surgery due to the recurrent pain; that the cyst looks small in size
From the tests and scans that i referred to above, could it be possible for another reason to be responsible for the pains apart from the renal cyst?
Please respond
From the tests and scans that i referred to above, could it be possible for another reason to be responsible for the pains apart from the renal cyst?
Please respond
Brief Answer:
MRI scan gives better resolution and clarity than CT scan.
Detailed Answer:
Hi again.
As per the reports available, there's no other cause mentioned in your question.
A complicated cyst( Bosniak 2), could cause the symptoms you mentioned.
Once surgery is done,your anxiety will be over in that case.
Otherwise, keep repeating the CT scan every 4-6 months, to know changes in the type of cyst,or any other cause for the pain.
Also, a MRI scan gives better resolution, than a CT scan.
Wish you good health.
MRI scan gives better resolution and clarity than CT scan.
Detailed Answer:
Hi again.
As per the reports available, there's no other cause mentioned in your question.
A complicated cyst( Bosniak 2), could cause the symptoms you mentioned.
Once surgery is done,your anxiety will be over in that case.
Otherwise, keep repeating the CT scan every 4-6 months, to know changes in the type of cyst,or any other cause for the pain.
Also, a MRI scan gives better resolution, than a CT scan.
Wish you good health.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Once again, thanks for your reply. I just did a MRI scan of the spine two weeks ago, is it medically safe to do another one again now? Then, what do I tell the technicians that I want to scan? Is it now a scan of the abdomen or where should they focus on?
Thanks.
Thanks.
Brief Answer:
MRI abdomen with contrast is needed.
Detailed Answer:
Hi again.
The difference between a CT scan and MRI scan is, mainly better clarity and
no radiation in MRI scan.
If you're going ahead with a MRI scan,it should be of the abdomen.
It should be done with contrast.
MRI scans are costlier than CT scans.
Your initial CT scan report was incomplete, as contrast enhancement in the cyst, was not mentioned.
You can send the reports here,for an expert opinion.
Wishing you good health.
Dr.Matthew J. Mangat.
MRI abdomen with contrast is needed.
Detailed Answer:
Hi again.
The difference between a CT scan and MRI scan is, mainly better clarity and
no radiation in MRI scan.
If you're going ahead with a MRI scan,it should be of the abdomen.
It should be done with contrast.
MRI scans are costlier than CT scans.
Your initial CT scan report was incomplete, as contrast enhancement in the cyst, was not mentioned.
You can send the reports here,for an expert opinion.
Wishing you good health.
Dr.Matthew J. Mangat.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dear Dr. XXXXXXX
I have uploaded relevant reports for your review...to show the sequence. I am unable to send the CT scan itself since it was put on a CD-ROM. On the scan are the following breakdown:
pre-contrast
Contrast
7-min delayed
Arterial view
Portal view
Sagital
Corona
I have uploaded relevant reports for your review...to show the sequence. I am unable to send the CT scan itself since it was put on a CD-ROM. On the scan are the following breakdown:
pre-contrast
Contrast
7-min delayed
Arterial view
Portal view
Sagital
Corona
Brief Answer:
Bosniak type 2 kidney cyst becoming malignant is 0 %.
Detailed Answer:
Hello XXXX.
Now that i've seen your CT scan reports, but not the scans, i've a better idea.
The actual scan films, would've given me an even better idea.
I'll change my advice now,as the report doesn't show anything to be worried about, and rush with an urgent surgery.
You can very well wait, for a repeat CT scan after 6 months, unless your pain is increasing and recurrent.
There's nothing to suggest a malignancy,from the reports.
Chance of Bosniak type 2 cyst becoming cancerous is 0%..!!
Type 2 Bosniak cyst, can be followed up, with repeat ultrasound/CT scan at 6 month intervals, and observation.
So enjoy life and forget about your kidney cyst for next 6 months.
Your lumbar spondylosis, if significant,can be cause for your backache.
Wish you well.
Bosniak type 2 kidney cyst becoming malignant is 0 %.
Detailed Answer:
Hello XXXX.
Now that i've seen your CT scan reports, but not the scans, i've a better idea.
The actual scan films, would've given me an even better idea.
I'll change my advice now,as the report doesn't show anything to be worried about, and rush with an urgent surgery.
You can very well wait, for a repeat CT scan after 6 months, unless your pain is increasing and recurrent.
There's nothing to suggest a malignancy,from the reports.
Chance of Bosniak type 2 cyst becoming cancerous is 0%..!!
Type 2 Bosniak cyst, can be followed up, with repeat ultrasound/CT scan at 6 month intervals, and observation.
So enjoy life and forget about your kidney cyst for next 6 months.
Your lumbar spondylosis, if significant,can be cause for your backache.
Wish you well.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I have attached screen shots of the CT scan...i am not Computer-proficient enough to know how to send the 3-D CT scan to you...it didn't upload when i tried. Hope this will help in your further opinion. Meanwhile, the pain is now localised on the left side of the hip-just below the stomach...
Sharp pain comes off and on
Sharp pain comes off and on
Brief Answer:
Preserve these CT scan films.
Detailed Answer:
Hello XXXX.
Congratulations. You've done an excellent job in sending the scan films.
You've also made it easier for me to advise.
Now, i wonder if your cyst is type 1 or 2.
So, you don't need to worry at all.
Anyway repeat the ultrasound or CT scan at 6 months.
This cyst is unlikely to cause a severe pain.
Avoid lifting heavy weights till the pain subsides.
Wish you good health and speedy recovery.
Dr.Matthew J. Mangat.
Preserve these CT scan films.
Detailed Answer:
Hello XXXX.
Congratulations. You've done an excellent job in sending the scan films.
You've also made it easier for me to advise.
Now, i wonder if your cyst is type 1 or 2.
So, you don't need to worry at all.
Anyway repeat the ultrasound or CT scan at 6 months.
This cyst is unlikely to cause a severe pain.
Avoid lifting heavy weights till the pain subsides.
Wish you good health and speedy recovery.
Dr.Matthew J. Mangat.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Wow...you have lifted up my spirits...but in the meantime, what drugs can i take for the flank pain? Do i just endure the pain?
Thanks.
Thanks.
Brief Answer:
Pain killers will reduce your pain.
Detailed Answer:
Hello XXXX.
Well, i don't know on what basis, your doctor predicted malignancy straightway.
Any way, keep in touch with your Urologist.
For your kind of pain,usually,we give anti-spasmodics.
After an examination only,dosage can be determined.
There's no need to tolerate the pain without medication.
Wish you well.
If you're happy with the answers, you may send your opinion to the site.
Dr.Matthew J. Mangat.
Pain killers will reduce your pain.
Detailed Answer:
Hello XXXX.
Well, i don't know on what basis, your doctor predicted malignancy straightway.
Any way, keep in touch with your Urologist.
For your kind of pain,usually,we give anti-spasmodics.
After an examination only,dosage can be determined.
There's no need to tolerate the pain without medication.
Wish you well.
If you're happy with the answers, you may send your opinion to the site.
Dr.Matthew J. Mangat.
Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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