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Suggest treatment for kidney stones

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Posted on Fri, 13 May 2016
Question: My urologist says that I have a narrow tube going out of one of my kidneys, which is restricting the flow of urine due to a collection of kidney stones. I had the shock wave procedure in the past, but new stones are collecting. The doctor recommended surgery that would cut out the narrow section of the tube and remove the stones. My GP's nurse practitioner said that this is a risky procedure. In the past, a prior urologist said that the removal of that kidney would be one treatment option, but he was not recommending that because the kidney is healthy and is still functioning, though at a lower level. My question is: what are the relative risks of the two procedures - the tube section removal or the entire kidney removal. Thank you.
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Answered by Dr. P. T. Patil (47 minutes later)
Brief Answer:
You have recurrence of stones due to PUJ obstruction .

Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted it appears that you have recurrence of urinary stones due to what is called as Pelvi Ureteric Junction (PUJ) obstruction.

I shall be happy if you can post me few more details to help me in making comments on your problem.
1) Was any time in past a radiological test called IVP done to assess the degree of PUJ obstruction and function of the kidney on that side ?
2) Was a test called DTPA scan done to assess the kidney function .


At the outset I would explain you what is PUJ obstruction.

During Intra Uterine Life the drainage system of the kidney consists of two separate portions
1) Pelvis of the kidney
2) Ureter .
Both these portion join together to form a single unit called Ureter that transmits urine from kidney down into Bladder .However in few cases there is diffect in union of these two portions resulting into partial or complete obstruction causing obstruction to flow of urine from kidney into bladder which leads to stagnation of urine in kidney and there by to formation of stones in the kidney That is what is happening in your case .

There are two treatment options for this condition that totally depends upon the status of kidney function .The primary aim of the treatment is to preserve the kidney

If the kidney function on affected side as determined by above mentioned tests is more than 25 % one can undergo surgery of Pyeloplasty where the affected segment is excised and the ureter continuity is restored .

However if the kidney is non functioning it is better to remove the kidney .

The nature of the surgery is same in both the cases and has no major risk involved ..
Now a days these surgeries are done by Laproscopic Technique which is non invasive and less traumatizing surgery.

Consult our Urologist and get these tests done before taking any decision regarding the surgery .

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
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Follow up: Dr. P. T. Patil (37 hours later)
I do not know if I had the IVP or DTPA tests - I think so, but need to check with the doctors on Monday to make sure. If I had these tests, are you going to ask for the results? I don't have a copy of any results, so I will have to get them if you need them. Thanks.
doctor
Answered by Dr. P. T. Patil (1 hour later)
Brief Answer:
Need reports to make precise comments

Detailed Answer:
Hello
Thanks for follow up
I can not make any siggesions unless I go through your reports .If you have not done these tests get them done now to help us In taking decision regarding surgery.
Thanks and Regards
Dr.Atil
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. P. T. Patil

Urologist

Practicing since :1971

Answered : 10342 Questions

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Suggest treatment for kidney stones

Brief Answer: You have recurrence of stones due to PUJ obstruction . Detailed Answer: Hello Thanks for your query,based on the facts that you have posted it appears that you have recurrence of urinary stones due to what is called as Pelvi Ureteric Junction (PUJ) obstruction. I shall be happy if you can post me few more details to help me in making comments on your problem. 1) Was any time in past a radiological test called IVP done to assess the degree of PUJ obstruction and function of the kidney on that side ? 2) Was a test called DTPA scan done to assess the kidney function . At the outset I would explain you what is PUJ obstruction. During Intra Uterine Life the drainage system of the kidney consists of two separate portions 1) Pelvis of the kidney 2) Ureter . Both these portion join together to form a single unit called Ureter that transmits urine from kidney down into Bladder .However in few cases there is diffect in union of these two portions resulting into partial or complete obstruction causing obstruction to flow of urine from kidney into bladder which leads to stagnation of urine in kidney and there by to formation of stones in the kidney That is what is happening in your case . There are two treatment options for this condition that totally depends upon the status of kidney function .The primary aim of the treatment is to preserve the kidney If the kidney function on affected side as determined by above mentioned tests is more than 25 % one can undergo surgery of Pyeloplasty where the affected segment is excised and the ureter continuity is restored . However if the kidney is non functioning it is better to remove the kidney . The nature of the surgery is same in both the cases and has no major risk involved .. Now a days these surgeries are done by Laproscopic Technique which is non invasive and less traumatizing surgery. Consult our Urologist and get these tests done before taking any decision regarding the surgery . 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.