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What Does The Following Kidney X-ray Indicate?

Posted on Mon, 16 Feb 2015

Question: Dear Sir,
I have been going through series of tests related to my urine flow issues. Here are the findings so far.
1. Grossly hydronephrotic right kidney with thin cortical rim, multiple areas of cortical thinning / scarring
2. Mild right ureter upto VU junction and no calculi
3. Prominent renal pelvis with narrowing at pelviureteric junction
4. Small sized irregular shaped right kidney - size 8.8 cm X 5.8 cm
5. Compensatory hypertrophy of left kidney with no calculi / hydroureteronephrosis - size 13.2 cm x 6.7cm

6. Delayed nephrographic phase noted after 1 hour film for right kidney noticed in X-ray IVP - Delayed Nephrogram and excretionary phases for right kidney. Left kidney showed excretion within 5 mins after injecting IVP.

7. PCS of right kidney appears dilated.
8. History of injury on backside
9. No obstruction in urethra, but urinary flow is not consistent.
10. Recurrent history of urine track infections, which were treated discreetly.
11. Suspected Neurogenic bladder (i.e. on medication for this now )
12. Left side back pain near pelvis with swelling of muscle with continuous pain
Tests done:
1. CT scan of KUB
2. X-ray with IVP
3. Ultrasound of abdomen

These are the impressions , in my reports.
Here are my questions.
1. Is this a life-threatening situation ?
2. Will there be a surgery required for fixing my right kidney, uretor?
3. Is it compulsory that I have to repair / remove my right kidney to live longer?
4. Will there be any other complications, if I undergo this treatment? Because I noticed that my semen output no longer there right now , after I went through urodynamics test and had catheter set for 4 days due to urine track infection, resulting from Urodynamics test. I wonder whether there is any other problems , which are going to come out this treatment for LUT Neurogenic blockage at bladder level.

Thanking you sir for sharing your impression and guidance.

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

Brief Answer:
You have non Functioning Rt. Kidney with compensated bigger Left Kidney.

Detailed Answer:
Hello
Thanks for your query,based on the facts and report of all the investigations that you have narrated I would summarize your problem.

You have congenital PUJ obstruction on Right side resulting into obstruction to flow of urine from kidney into ureter and bladder and there by reducing function of the Right kidney gradually over a period of 40 years and has almost become non functioning unit.This obstruction to flow of urine down into ureter results into stagnation of (residual urine) in renal pelvis has been the cause of repeated episodes of UTI and thinning out of renal cortex which is main part of the kidney that deals with production of urine and excretion of waste products.

Nature has taken care of this by increasing the size of the Left kidney to compensate functions of the affected kidney..

In view of the reality, you have to accept the fact that you have only one functioning renal unit the other being source of infection .

I would like to answer your queries point to point.

1) It is not life threatening situation provided you deal with diseased kidney by removing it ( Nephrectomy).There are so many people having only one kidney from birth and live their normal life .
2) Since your Right kidney is the source of infection it is always advisable to remove the diseased kidney and prevent transmitting infection to other normal kidney which may result in to Chronic Renal Failure .
3) Yes removing the Rt kidney will ensure you to have normal life and live longer.
4)Kidney has no role to play in process of Erection.All the symptoms that you had were due to UTI.

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. Bhagyalaxmi Nalaparaju

Follow up: Dr. Dr. P. T. Patil (23 hours later)

Dear Sir,
Thank you for your detailed response and guidance. I have a few more related queries. Please review these as well and clarify these too.

1. Is it fine, if I lift some heavy weight objects right?

2. Is it fine to have Intercourse, while having this issue with kidneys ? Will there be any other problems like UTI transmission to my wife from me ? In the past, my wife had UTI after Intercourse on some occasions. Will her health and especially her kidneys be affected severely right now?

3. My wife also had a history of UTI . She went through cystoscopy before, after which her UTI frequency has gone down. If she develops UTI right now, will it also cause infection in my urinary track and affect my kidneys again?

4. Are there any other risks associated me having Intercourse ?

Thanking you,
Yours Sincerely

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

Brief Answer:
Read Detail answers bellow.

Detailed Answer:
Hello Thanks for writing again.
Here are answers to your questions.
1)Yes you can lift heavy objects even after removing your Rt .Kidney.

2 & 3) You can have protected sex(using condom) to avoid infection being transmitted to your wife and vice a verse.
4) There is no other risk in having sex provided your UTI is well treated and practice safe ,protected sex..
Thanks and Regards.
Dr.Patil.

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