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Suggest Treatment For Hydronephrosis

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Posted on Sat, 28 Mar 2015
Question: Hello, I have been having significant pain in my right flank for a couple of months. Recently it has increased dramatically and I pushed for my MD to run some tests. I have been having constant nausea, fatigue, and weight loss. They ran blood tests as well as an abdominal ultrasound, as I have a history of kidney stones. My test came back normal with the exception of the ultrasound. My right kidney has not only became smaller, by there is significant thinning of the renal cortex. Now just to give you some hx, I have permanent damage to my right uretur due to the amount of stones. It is stretched out and has scar tissue through out. Almost every ultrasound that I have had over the past 5 years has shown hydronephrosis even when there are no stones present. I am a little flustered because over the past few months my physician hasn't seemed to be concerned of the chronic nephrosis because he says there are no visible obstructions. Now that I'm being told that there is significant renal cortex thinning, I don't know what to think. I am in a very large amount of pain in my flank area. It is so intense that It has impacted my daily life. My gfr is perfect at 59, my creatinine is 1.0, and my BUN is also in the normal range, which is wonderful, but because of this my MD doesn't believe there is any cause for concern. Please tell me what to do because I am at a loss. I have lost 18 pounds in 2 months, I am in constant pain, and I can't even take a deep breath without wanting to cry. What is wrong with me?
doctor
Answered by Dr. Rakesh Madhyastha (3 hours later)
Brief Answer:
Immediate attention required

Detailed Answer:
Hello

I understand your concern, it must be very debilitating for you to live with the pain.
The fact that you have hydronephrosis associated with pain without urinary tract infection means that the renal capsule is gettjng stretched. This required immediate evaluation by a urologist.
Here is what I suggest
1. Get a contrast enhanced ct scan of kidney ureter and bladder
2. based on where the obstruction is the urologist will decide to decompress either with a dj stent or a nephrostomy
3. for now I recommend Tylenol for pain and tramadol of the pain is very severe

The root cause of pain should be evaluated, it is unacceptable to live with pain

I hope I was of help, if you have any further queries please get back to me

Regards
Note: For further queries related to kidney problems and comprehensive renal care, talk to a Nephrologist. Click here to Book a Consultation.

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

Nephrologist

Practicing since :2009

Answered : 4364 Questions

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Suggest Treatment For Hydronephrosis

Brief Answer: Immediate attention required Detailed Answer: Hello I understand your concern, it must be very debilitating for you to live with the pain. The fact that you have hydronephrosis associated with pain without urinary tract infection means that the renal capsule is gettjng stretched. This required immediate evaluation by a urologist. Here is what I suggest 1. Get a contrast enhanced ct scan of kidney ureter and bladder 2. based on where the obstruction is the urologist will decide to decompress either with a dj stent or a nephrostomy 3. for now I recommend Tylenol for pain and tramadol of the pain is very severe The root cause of pain should be evaluated, it is unacceptable to live with pain I hope I was of help, if you have any further queries please get back to me Regards