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Renogram for ureterogavinal fistula showed good drainage. Loin pain, trace protein urine, tired. Need advice

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hello anyone there, i really need some advice, I have to have renograms regularly due to having a ureterogavinal fistula but need to know what to ask the consultant next visit. my split function on last renogram was 46% and 54% showed good drainage, etc, nothing out of the ordinary but am worried this will deteriorate. my bloods are all normal including egfr,u&e, crp. but have loin pain, trace protein urine, and am so tired all the time. I had this problem starting from 2 operations, laparotomy being one. i have been under anaesthetic 4 times in last 9 months. I have scarring on both ureters, enlarged kidney and was told reflux,hydronephrosis but this was when had fistula last year. need advice please
Posted Tue, 5 Jun 2012 in Kidney Conditions
Answered by Dr. Raju A.T 8 hours later

Thanks for your query.

The loin pain, protein in the urine, and the excess fatigue are secondary complications of your underlying problem.I would not say due to function deficit of the kidneys but due to physical alteration caused by the surgeries you underwent.

It will take few more months for you to have symptom free days.

As far the ureteric scarring and its complication Hydronephrosis is concerned, I would want you to follow up the progress of both the above conditions regularly.As these conditions are ones which can hinder the renal function in you.This can be done by regular ultrasound scan to know the severity of hydronephrosis.If any rapid worsening is seen then you can go for ureter reimplantation surgeries or simply revision with stents would suffice depending on the severity.If no progression and reduction in hydronephrosis is noticed then there would be no need to be worried and within few months your renals may come to normal.

Thought on excision of the fistula has to be considered as in some it can cause hydronephrosis by itself.Do ask on the same to your treating doctor.

The split renogram readings appear ok, there is no need to worry but regularly follow up on them.The renogram will surely show good improvement if the hydronephrosis is not worsening.Hence, Hydronephrosis is matter of main concern in you.

Hope I have answered your query. Let me know if I can assist you further.

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