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Suggest treatment for malrotated kidney, large cyst, UPJ obstruction and hydronephrosis

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Posted on Fri, 15 May 2015
Question: I have a malrotated rt. kidney, with a large cyst, a upj obstruction, and hydronephrosis.
what is the treatment for this? what is the recovery time? does it require a hospital stay? I have already had a stent placed, but that was several years ago. I only have 3/4 of a kidney on the rt.
My urologist told me my lt kidney is the size of a walnut, and the rt kidney is the size of a softball, filled with urine.
doctor
Answered by Dr. P. T. Patil (1 hour later)
Brief Answer:
Needs furher evaluation.

Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted I would summarize your problems that you have small atrophied Left kidney with Hydronephrotic Rt kidney due to PUJ obstruction with large Cyst..

I shall be happy if you can post me few more details to help me in making comments on your problem.
1) Have you ever done Intra Venous Pyelography(I.V.P) to know the function of both the kidneys and degree of PUJ obstruction?
2) Have you done DTPA renal scan to confirm the split renal function and to know the status of left kidney?(This is very important before you decide to go for correction of PUJ on Right side.)
3) Renal Function Tests.

Please get these investigations done under guidance of your Urologist to assess the kidney function on both sides and plan next course of action.

The PUJ obstruction with Cyst in the Right Kidney has to be treated surgically by doing Pyeloplasty and deroofing of cyst.

The left kidney can be left alone depending on status of it's function .

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. Yogesh D
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Follow up: Dr. P. T. Patil (13 hours later)
My lab values are fine. I have had the lasix renogram, and there is no problem with the function of the kidneys. I have also had many IVP's showing the cyst and obstruction. I would like to know how serious/risky the surgery would be. Is it outpatient? what is the recovery time, (how long would I have to be off work, etc?) I would appreciate all the info you can give me about the surgery. Also is it done by a urologist, or is it going to require a nephrologist?
Thanks for your help.
doctor
Answered by Dr. P. T. Patil (1 hour later)
Brief Answer:
The surgery is not risky at all.

Detailed Answer:
Hello
Thanks for writing again.

Pyeloplasty and Deroofing of Cyst can be done by minimally accessive surgery (Laproscopic Surgery )in one sitting by a well trained Urologist.

You will need to get hospitalized for 4-5 days and will need to off work for 10 days.

Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
doctor
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Follow up: Dr. P. T. Patil (36 minutes later)
Thank you
doctor
Answered by Dr. P. T. Patil (8 hours later)
Brief Answer:
Please go ahead and get surgery done

Detailed Answer:
Hello
Thanks for follow up.
Go ahead and get operated.
Thanks and Regards.
Dr.Patil.
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 : 10362 Questions

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Suggest treatment for malrotated kidney, large cyst, UPJ obstruction and hydronephrosis

Brief Answer: Needs furher evaluation. Detailed Answer: Hello Thanks for your query,based on the facts that you have posted I would summarize your problems that you have small atrophied Left kidney with Hydronephrotic Rt kidney due to PUJ obstruction with large Cyst.. I shall be happy if you can post me few more details to help me in making comments on your problem. 1) Have you ever done Intra Venous Pyelography(I.V.P) to know the function of both the kidneys and degree of PUJ obstruction? 2) Have you done DTPA renal scan to confirm the split renal function and to know the status of left kidney?(This is very important before you decide to go for correction of PUJ on Right side.) 3) Renal Function Tests. Please get these investigations done under guidance of your Urologist to assess the kidney function on both sides and plan next course of action. The PUJ obstruction with Cyst in the Right Kidney has to be treated surgically by doing Pyeloplasty and deroofing of cyst. The left kidney can be left alone depending on status of it's function . 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.