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Suggest Treatment For Pain Due To Stricture Of Reter Due To Injury
Question: Hi doctor, my wife has got a right sided ureter stricture after one cyst removal laparoscopy in 2010. Now she has mild hydronephrosis and also she has symptoms of endometriosis . She suffers from severe right side abdominal pain from first day of her period till 10th day. No pain or any other issues till next cycle. She has been managing pain by taking spasmo proxyvon twise a day during these ten days. Now this medicine is not available and one doctor suggested hyocimax 20 mg SOS . Pl advice. Is my pain during period due to stricture? Pl advice correct medicine to manage my pain during these ten days. I am taking homeopathic medicine for ureter stricture to avoid surgery.
Brief Answer:
Pain is not due to Stricture of Ureter.
Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted it appears that your wife has developed stricture of Ureter due to injury to the Ureter during laproscopic surgery done in 2010.
The pain that she has is mostly due to flaring up of congestion of pelvic organs during peri menstrual period .Please give her pain killers like Cyclopam twice daily during episodes of pain.
As regards Ureteral stricture get her IVP done to find out the extent of stricture and degree of obstruction to flow of urine and back pressure changes in kidney.If she has grade 2 or more hydronephrosis she may need to undergo endoscopic surgery of ureterotomy or open surgery to restore the continuity of ureter.This will help to save her kidney from further damage.
I personally feel that no medicine is going to cure her stricture as it is a mechanical obstruction due to injury and not due to any disease.
Hope I have answered your query ,please feel free to ask if you have more questions ,
I shall be happy to help you
Thanks and Regards.
Dr.Patil.
Pain is not due to Stricture of Ureter.
Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted it appears that your wife has developed stricture of Ureter due to injury to the Ureter during laproscopic surgery done in 2010.
The pain that she has is mostly due to flaring up of congestion of pelvic organs during peri menstrual period .Please give her pain killers like Cyclopam twice daily during episodes of pain.
As regards Ureteral stricture get her IVP done to find out the extent of stricture and degree of obstruction to flow of urine and back pressure changes in kidney.If she has grade 2 or more hydronephrosis she may need to undergo endoscopic surgery of ureterotomy or open surgery to restore the continuity of ureter.This will help to save her kidney from further damage.
I personally feel that no medicine is going to cure her stricture as it is a mechanical obstruction due to injury and not due to any disease.
Hope I have answered your query ,please feel free to ask if you have more questions ,
I shall be happy to help you
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you doctor.
1. Pl advice cyclopam tablet dosage and mg. We tried hyocimax 20 mg but no relief. Is it alternative to spasmo proxyvon? Can we manage with this pain killer 10 days every month? Is there any side effects for continuous usage?
2. Hydronephrosis is mild to moderate . She had undergone ct and MRI and found narrowing at bottom of right ureter with ureter dilated till kidney. But flow is there. Tried ureter stenting twice already. Since she has endometriosis, gynec suggested for uterus removal and we are trying to avoid the same as well to see the improvement of stricture. How long can we wait with hydronephrosis without kidney damage? It has been 4 years now. In case of uterus removal is needed, we thought of doing together for stricture as well.
3. Will ureter reconstruction surgery creates further complications in future? That is what worrying us to avoid surgery. Pl advice doctor. She has been undergoing severe depression due to this every month 10 days pain. Can this surgery creates further scar tissues and cause further problems?
We want to save the kidney. Can we wait since the hydronephrosis is not increasing compared to previous years
Pl advice
1. Pl advice cyclopam tablet dosage and mg. We tried hyocimax 20 mg but no relief. Is it alternative to spasmo proxyvon? Can we manage with this pain killer 10 days every month? Is there any side effects for continuous usage?
2. Hydronephrosis is mild to moderate . She had undergone ct and MRI and found narrowing at bottom of right ureter with ureter dilated till kidney. But flow is there. Tried ureter stenting twice already. Since she has endometriosis, gynec suggested for uterus removal and we are trying to avoid the same as well to see the improvement of stricture. How long can we wait with hydronephrosis without kidney damage? It has been 4 years now. In case of uterus removal is needed, we thought of doing together for stricture as well.
3. Will ureter reconstruction surgery creates further complications in future? That is what worrying us to avoid surgery. Pl advice doctor. She has been undergoing severe depression due to this every month 10 days pain. Can this surgery creates further scar tissues and cause further problems?
We want to save the kidney. Can we wait since the hydronephrosis is not increasing compared to previous years
Pl advice
Brief Answer:
Both the surgeries can be done inone sitting.
Detailed Answer:
Hello
Thanks for highlighting details .
The hydronephrosis is due to uerter being pinched (Injured ) at lower end during previous surgery .This will not get resolved with any medical treatment hence it is better to get it repaired .Since she has severe pain in abdomen due to endometriosis it is advisable to get hysterectomy done to resolve the issue permanently.The ureter reconstruction or re-implant and removal of ureter can be done in one sitting by a team of Gynaecologist and Urologist .This will definitely help her to get relief from pain and save the kidney from further damage.
Thanks and Regards.
Dr.Patil.
Both the surgeries can be done inone sitting.
Detailed Answer:
Hello
Thanks for highlighting details .
The hydronephrosis is due to uerter being pinched (Injured ) at lower end during previous surgery .This will not get resolved with any medical treatment hence it is better to get it repaired .Since she has severe pain in abdomen due to endometriosis it is advisable to get hysterectomy done to resolve the issue permanently.The ureter reconstruction or re-implant and removal of ureter can be done in one sitting by a team of Gynaecologist and Urologist .This will definitely help her to get relief from pain and save the kidney from further damage.
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you doctor. Pl clarify my final queries
1. The option of ureter repair and uterus removal at one go was suggested. But we are worried about below issues
Chances of reoccurrence of stricture even after surgery. Further complications etc. pl provide your valuable opinion on this. Is this a major complicated surgery which can further spoil her life?
2. Hormone imbalance and life after uterus removal. Pl advice
3. Can we wait for one more year managing with cyclopam? Is there any risk?
Pl provide me your opinion and advice on above three queries based on your experience and expertise.
Appreciate your quick support and advice..
1. The option of ureter repair and uterus removal at one go was suggested. But we are worried about below issues
Chances of reoccurrence of stricture even after surgery. Further complications etc. pl provide your valuable opinion on this. Is this a major complicated surgery which can further spoil her life?
2. Hormone imbalance and life after uterus removal. Pl advice
3. Can we wait for one more year managing with cyclopam? Is there any risk?
Pl provide me your opinion and advice on above three queries based on your experience and expertise.
Appreciate your quick support and advice..
Brief Answer:
Not to be worried about recurrence of stricture.
Detailed Answer:
Hello
Thanks for follow up.
In a experienced hand there is nothing to be worried about the surgery and recurrence of stricture .Usually ureter is implanted in Bladder with a wide spatulated opening .
There is no issue of hormonal imbalance as uterus has no role in production of Hormones Hormones are produced by Ovaries and not by uterus.and ovaries are preserved during surgery.of removal of uterus.(Hysterectomy).
Waiting for one more year is not going to change the outcome of the problem and will not help at all.
Please go ahead and get the surgery done at earliest.
Thanks and Regards.
Dr.Patil.
Not to be worried about recurrence of stricture.
Detailed Answer:
Hello
Thanks for follow up.
In a experienced hand there is nothing to be worried about the surgery and recurrence of stricture .Usually ureter is implanted in Bladder with a wide spatulated opening .
There is no issue of hormonal imbalance as uterus has no role in production of Hormones Hormones are produced by Ovaries and not by uterus.and ovaries are preserved during surgery.of removal of uterus.(Hysterectomy).
Waiting for one more year is not going to change the outcome of the problem and will not help at all.
Please go ahead and get the surgery done at earliest.
Thanks and Regards.
Dr.Patil.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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