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What Do The Following Test Reports Indicate?
Question: Hi, i am 30f, incidentally identified with mild hydronephrosys of right kidney during routine medical check up. My doctor has advised me to go for IVP n then for DTPA scan. There are deference of opinion by various doctors. Some has adviced me to go for pyeloplasty. Other doctors says that it is rare case of congenital mega calyces. My IVP and DTPA scanning images are uploaded herewith. Please advise.
Brief Answer:
Please upload and share your IVP and DTPA reports for discussion
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. I understand the various opinions given by different doctors. However your IVP and DTPA scan reports are important to be analyzed to assess your situation accurately.
2. I am unable to find any IVP and DTPA report attached with this query.
3. Please share your IVP and DTPA report in the following ways
(i) You might scan the ultrasound scan report and upload a pdf copy of the report by clicking on the attach report or upload report button.
(ii) You might email the report to YYYY@YYYY and write "query Id 210708 KIND ATTN DR XXXXXXX CHAIL" on the subject line.
(iii) You might email the report to YYYY@YYYY and write "query Id 210708 KIND ATTN DR XXXXXXX CHAIL" on the subject line.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr XXXXXXX
Please upload and share your IVP and DTPA reports for discussion
Detailed Answer:
Hi XXXX,
Thanks for writing in to us.
I have read through your query in detail.
Please find my observations below.
1. I understand the various opinions given by different doctors. However your IVP and DTPA scan reports are important to be analyzed to assess your situation accurately.
2. I am unable to find any IVP and DTPA report attached with this query.
3. Please share your IVP and DTPA report in the following ways
(i) You might scan the ultrasound scan report and upload a pdf copy of the report by clicking on the attach report or upload report button.
(ii) You might email the report to YYYY@YYYY and write "query Id 210708 KIND ATTN DR XXXXXXX CHAIL" on the subject line.
(iii) You might email the report to YYYY@YYYY and write "query Id 210708 KIND ATTN DR XXXXXXX CHAIL" on the subject line.
Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.
Hope your query is answered.
Do write back if you have any doubts.
Regards,
Dr XXXXXXX
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Reports sent
Brief Answer:
Please find details below
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. I have seen through your reports in detail. Megacalyces is not progressive and surgical treatment is not necessary unless there are complications.
2. I have reviewed about a similar case like yours in a 22 year old woman who had similar findings at a routine ultrasound scan and was diagnosed as megacalyces involving one kidney (Puigvert's Disease). At the same time it will help to know if you ever had any severe kidney or urinary tract infection anytime from childhood.
3. Apart from the above, I have also read about 3 other patients who have had similar problems. In all 1 out of the 4 cases involved both kidneys and 3 patients had this condition present only involving a single kidney with the other kidney normal.
4. In the 22 year old woman also the right kidney was involved and she was also having small stones probably as a result of megacalyces. However there was no outflow obstruction however stasis in upper urinary tract was noted. In this particular patient, the split renal function of right kidney was 42 percent of total renal function. Subsequently the patient was monitored for 22 months and the repeat evaluation showed the urinary stones were same and there was no progression of the condition.
5. If your problem has been diagnosed as megacalyces then treatment should be directed at controlling urinary-tract infections with appropriate antibiotics and attempting to minimize stone formation with adequate fluid intake. Please avoid holding urine for long periods of time. At the same time, any suspected urinary obstruction involving right kidney has to be ruled out by doing detailed tests, should there be any doubt in the mind of your urologist.
6. You have expressed that there is a significant difference in opinion among your doctors with some of them suspecting obstructive uropathy involving right kidney which is a concern and requires pyeloplasty to be done. To solve this problem, it is important to know if any stones are unnoticed in the right kidney or ureter which might be remotely causing obstruction. For this a clinical examination is important and if doubt of any mild obstruction persists then some doctors might suggest a CT KUB region. This is because IVP might not show all atones due to bowel gas and CT KUB will show a stone even measuring 2 to 3 mm in size. This particular point has to be discussed in detail with your urologist. It is true that you never experienced any pain in right kidney region and therefore the possibility of obstruction due to stone or any other cause is less but this might require double confirmation.
7. I would like to know exact details of your discussions with your doctors including whether you have taken opinion from more than one urologist and what each of them have opined. I would also like to know if they have recommended any more tests.
I wish to continue this discussion after hearing updates from you.
Regards,
Dr.Vivek
Please find details below
Detailed Answer:
Hi XXXX,
Thanks for writing back with an update.
1. I have seen through your reports in detail. Megacalyces is not progressive and surgical treatment is not necessary unless there are complications.
2. I have reviewed about a similar case like yours in a 22 year old woman who had similar findings at a routine ultrasound scan and was diagnosed as megacalyces involving one kidney (Puigvert's Disease). At the same time it will help to know if you ever had any severe kidney or urinary tract infection anytime from childhood.
3. Apart from the above, I have also read about 3 other patients who have had similar problems. In all 1 out of the 4 cases involved both kidneys and 3 patients had this condition present only involving a single kidney with the other kidney normal.
4. In the 22 year old woman also the right kidney was involved and she was also having small stones probably as a result of megacalyces. However there was no outflow obstruction however stasis in upper urinary tract was noted. In this particular patient, the split renal function of right kidney was 42 percent of total renal function. Subsequently the patient was monitored for 22 months and the repeat evaluation showed the urinary stones were same and there was no progression of the condition.
5. If your problem has been diagnosed as megacalyces then treatment should be directed at controlling urinary-tract infections with appropriate antibiotics and attempting to minimize stone formation with adequate fluid intake. Please avoid holding urine for long periods of time. At the same time, any suspected urinary obstruction involving right kidney has to be ruled out by doing detailed tests, should there be any doubt in the mind of your urologist.
6. You have expressed that there is a significant difference in opinion among your doctors with some of them suspecting obstructive uropathy involving right kidney which is a concern and requires pyeloplasty to be done. To solve this problem, it is important to know if any stones are unnoticed in the right kidney or ureter which might be remotely causing obstruction. For this a clinical examination is important and if doubt of any mild obstruction persists then some doctors might suggest a CT KUB region. This is because IVP might not show all atones due to bowel gas and CT KUB will show a stone even measuring 2 to 3 mm in size. This particular point has to be discussed in detail with your urologist. It is true that you never experienced any pain in right kidney region and therefore the possibility of obstruction due to stone or any other cause is less but this might require double confirmation.
7. I would like to know exact details of your discussions with your doctors including whether you have taken opinion from more than one urologist and what each of them have opined. I would also like to know if they have recommended any more tests.
I wish to continue this discussion after hearing updates from you.
Regards,
Dr.Vivek
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
Answered by
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