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Severe flank pain. Suspected for cyst or diverticulum in lower kidney. Required treatment?

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Hello. My 14 yr old son has hematuria and a possible cyst or diverticulum in lower pole of right kidney. Non- moveable margin and moveable possibly stone inside. He has dull flank pain with intermittent sharp pain. We are waiting to XXXXXXX a urologist next week but I am extremely nervous. I am a hospice nurse and just need to know if I should be worried. What is most likely the treatment for this condition?
I should say the area of concern is 2cm. He also has a stone in bottom of right kidney and 3 stones in left kidney.
Posted Fri, 15 Mar 2013 in Kidney Conditions
Answered by Dr. Ravi Bansal 3 hours later

Thanks for the query.

I would like to know which side of the flank is paining.

Hematuria and flank pain is a common symptom of kidney stones . But do not worry, he will get better.

However, we need to:
1. Confirm the position and size of the stones best done by CT scan of the kidney
2. Rule out urine infection by urine routine and urine culture examination.
3. Investigate for the cause of kidney stones at 14 yr of age - metabolic derangement - include testing for kidney function test iPTH, calcium, phosphorus, acidosis measurement, etc.

All these should be done under the guidance of your nephrologist/urologist.

If the stones are 5mm or above the patient would need surgery for stone removal - the type of surgery will be depending on the exact size and location of the stones.

If you have ultrasound or CT reports, I would like to look at it. You can upload the reports using this site's uploader present on the webpage. Alternatively you can choose to mail me at YYYY@YYYY . Address the mail with subject line as Attn:Dr. Ravi bansal

Hope this helps. I will be available for further guidance.

Above answer was peer-reviewed by
Follow-up: Severe flank pain. Suspected for cyst or diverticulum in lower kidney. Required treatment? 31 minutes later
Hello! Thank you for replying. Urine is clear for any infection and labs so far have been ok. He is having right side flank pain and that is the same side as mass. I guess I am not as concerned with the stones as I am the cyst. I don't have a copy of ct report or ultrasounds that were done. I just wondered what treatment is for the cystic area. The only details I have of that area is it is in lower pole of right kidney and is solid margin with a moveable solid inside that they think may be a stone and size is 2cm by 2cm. Ultrasound showed no blockage and Doppler was used. He is scheduled for a ct with contrast on Tuesday. I wonder what treatment could be and the possibility of cancer. The urologists nurse informed me dr needs better look to determine if diverticulum or cyst??? We have been waiting two weeks and one ct and three ultrasounds later we still have no answer.
Answered by Dr. Ravi Bansal 2 hours later
I can understand your doctors difficulty. Cystic lesion in the kidney may be-
1. Benign cyst- where nothing to be done. It can be left alone.
2. Cystic tumor- which may or may not need surgery.

Sometimes it is difficult to differentiated between the two. We might needed contrast CT KUB / MRI , Urine testing for malignant cells- for differentiation.

If the above tests doesn't provide any clues about the nature of the cyst, then if there is a solid component in the cystic area and doubts about of tumor persist, then the kidney should be removed.

At this point, I think we should wait for the contrast ct report. It will definitely give us better clues.

Hope this answers your query. I will be glad to answer your other concerns.

Best wishes.

Above answer was peer-reviewed by
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