Category Archives: Urological Issues

After removal of stone from my left kidney naturally, I observed frequent drops of pus. I consulted with kidney specialists at SIUT Karachi Pakistan. They, after a series of tests declared that my left kidney has got infection, according to report, Daie Cell observed 0.3%, Tissues 0.2%, Creatinine 2.9, Pus18%, Platelets in blood reduced to 2200, Ultrasound revealed that left kidney collapsed by 0.3 cm. I am feeling pain and pus+ blood mixed drops are continuously discharging. The tests also revealed the presence of infection in cum-discharge. Doctors suggests two options to me. One to immediately remove this infected kidney, the body will be maintained on one kidney which is healthy. Second to undergo Laser Cystoscopic Surgery, in which infected part of your kidney will be cut-cleaned and cured for infection, the option being not available in Pakistan. I was advised to go UAE for this operation. My question to this worthy forum is to suggest me if the treatment of infected kidney is better option or the simply removal of kidney is good one. I am in doubt if this infection may re-occur even after having Laser Surgery..? An early reply is appreciated, please.

The question that you ask is a urological question.  I am a nephrologist and have no expertise in surgery or surgical treatment of kidney disease.  I suggest that you consult with your urologist, who is a kidney surgeon. If you … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Symptoms and Side Effects, Treatments, Urological Issues

I have a friend with severe pain in her back, left side. A CT scan showed a 2 cm cyst. She had an ultrasound and they diagnosed it as Indeterminant left renal lesion. She has had pain off an on for a few years. 2 years ago, this cyst was 1 mm. Her pain is very real and severe. At this time, they do not intend to do anything. Is there any other reason she would have this pain? She does have blood in her urine but according to the doctors, no infection. I am very worried about her and think there should be a next step.

A simple cyst on a kidney does not ordinarily cause pain.  I suggest that you consult with a urologist about further studies to be done on the lesion that has been identified on the left kidney.  I am a nephrologist … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney Cysts, Kidney-Related Health Questions, Nephrologist, Symptoms and Side Effects, Treatments, Urological Issues

My Grandfather has CKD. Usually his baseline creatinine is 2.7. Sometimes his creatinine goes as high as 3.5. Sometimes it goes back to 2.7. He has ureteral stents inside to protect his kidneys from a blockage and hydronephrosis. He’s had his latest stents in since Dec 2016. Scheduled to have them replaced this month. Latest labs shows creatinine gone up again to 3.4. Could this be from the stents being in too long this time? They’ve been in this time about five months. Or is it something else? What can my Grandfather do to get his creatinine back to baseline? Can a fresh stent replacement this month cause the creatinine to go down again? Or will creatinine rise higher?

Long term ureteral stents are commonly changed every 3 to 6 months.  This is a procedure performed by a urologist.  This is done to prevent the build up of scale and calcium on the stents that may cause further blockage … Continue reading

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Hydronephrosis and Hydroureter, Kidney-Related Health Questions, Laboratory Testing, Urological Issues

My 91 year old mother had 2 UTIs in January. She saw a urologist in late February. He referred her to a nephrologist who diagnosed her with stage 3 kidney disease in March. We have seen a rapid decline in her cognitive function since the first UTI (3 month time period). Is there a correlation between kidney disease and cognitive function? We keep asking about dementia and additional tests that should be run. We are told by the SN facility that there is nothing more they can do and they have no explanation for her sudden onset dementia.

Dementia is common in the elderly and may be worsened by infections of any kind, including urinary tract infections (UTI’s).  Early stage chronic kidney disease (CKD Stage 3) should not be a cause of dementia.  I can only suggest that … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, GFR, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Symptoms and Side Effects, Urinary Tract Infection/Pyelonephritis, Urological Issues

My 95 year old mother had a CT scan last August, then an ultrasound in Jan of this year. Her symptoms were daily mild nausea, lack of appetite, hard little stomach (but she also has extreme kyphosis due to multiple compression fractures over the last 5 or 6 years). The report showed an 8.4cm cyst on her uterus, which she doesn’t have, so PA nurse explained it must be on her bladder. The ultrasound in Jan. showed it had grown to 9.6cm and that report called it a mass. She has started getting a pain in her groin from time to time that is relieved when she urinates. Both reports showed hydronephrosis of one kidney. Her blood work is good but about 9 months ago her potassium was up slightly and they had monitored that. In the past 3 or 4 months she has developed really bad edema in her legs and feet; she had always had some, mostly her ankles and feet but now its that way well above her knees. She has gone from hovering at about 98 -100 lbs to 115 at an appointment earlier this week. That appointment was with her Primary doctor. I hand delivered the reports (which had been done by a gastro doctor) and called many times to ask if she was going to refer my mom to a urologist. I kept getting the answer that they were waiting for more information from the gastro doctor. I finally got her an earlier than usual appointment to come in to see the Primary doctor and she said very little about the reports of the cyst/mass and concentrated on the fact that her blood work and recent urinalysis was all good. My mother has atrial fibrillation and sees a cardiologist also. I asked did she also need to see her cardiologist sooner than her regular appointment, 2 months away. She said no, that she would prescribe a stronger diuretic, and suggested another ultrasound in about 6 weeks to monitor the cyst/mass (almost 10 cm!) Should I just make an appointment for her with a urologist myself? Am I overreacting? I know my mother would not put herself through surgery, she has said so, so is it reasonable for her doctor to feel like there is nothing to do for her so why send her and increase her anxiety about it all. I almost get the feeling that the doctor, who both my mother and me have always liked, thinks she is at the end so just let it all be. What should I do?

The question that you ask is a urological question.  I am a nephrologist and have no experience with surgical evaluation and treatment of kidney tumors.  This should be directed to a urologist who is a surgeon.  Evaluation of masses and … Continue reading

Posted in Ask the Doctor, Symptoms and Side Effects, Urological Issues

Is there an experimental tube that can drain or help kidney urine flow from the inside? Or is the external drain tube the only one? Is there an internal drain tube which doesn’t require a bag that can relief pressure and drain urine from inside out?

I believe that you are asking about the use of internal ureteral stents (plastic tubes placed into the kidney from the bladder) versus percutaneous nephrostomy stents (plastic tubes inserted into the back from the outside and into the kidney to … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions, Urological Issues

I had a kidney tumor removed (partial nephrectomy) – was clear cell renal carcinoma limited to the kidney – grade 1 (2.4cm) but stage 4 (WHO/ISUP 4) with clean margins. Pathology said it had sarcomatoid differentiation (95% sarcomatoid element) and extensive necrosis, extreme nuclear pleomorphism, multinucleate giant cells and /or rhabdoid sarcomatoid differentiation. Adrenal gland not identified and regional lymph noded pnx (could not be assessed. Pt1a grade. 5 questions: 1. Because it was grade 4 my doctor is recommending full removal of the kidney in 6 weeks. Is that the recommended course of action – is it likely that recurrence would be at that kidney again and removal lessens my chance of recurrence? 2. Should I have a PET scan, brain scan, bone scan, etc now since it was grade 4? They are saying just a chest CT is required now? 3. Is my likelihood of recurrence or distant metastes high because it was grade 4 even though it was very small stage 1a? Lots of conflicting information? 4. If the tumor was removed am I considered disease free and now just need aggressive regular surveillance? 5. How would I know if there was microvascular invasion and is the necrosis and sarcomatoid indicators of a recurrance? I’m quite scared so thank you so much for answering my questions!

The questions that you ask are surgical questions and must be asked of a urologist.  I am a nephrologist and do not have any surgical expertise in regards to kidney cancers.  If you have concerns about the opinions of your … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney Cancer, Kidney-Related Health Questions, Nephrectomy / One kidney, Treatments, Urological Issues

Hello Doctor, My query is for my Mom. She is around 55 yrs of age, having diabetes and BP. Recently we took CT scan, and we came to know that she is having kidney stone in her left side. The report says “39×28 mm sized large branching calculus is seen in left renal pelvis, extending into lower calyx. Upper and middle calyxes are dilated and clubbed.” My query is what type of treatment required to remove it? Is it possible to remove the stone using “Lithotripsy”? Pls comment on it. She is diabetic but due to a controlled diet she is having 128 value after 2 hrs of breakfast. Though sugar is under control, would like to avoid going to surgery or Tunnel Surgery (Percutaneous Nephrolithotomy). Advance thanks for your reply.

The question that you ask is a urological question.  I am a nephrologist and have no expertise in regards to the surgical treatment of kidney stone disease.  I suggest that you consult with a urologist, who is a surgeon. For … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Diabetes, Kidney Stones, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Treatments, Urological Issues

My father-in-law was diagnosed with benign prostatic hyperplasia, urolithiasis, chronic kidney disease secondary to obstructive uropathy. He has been experiencing recurrent UTI, and keep complaining of pain at hypogastric area. He became drug dependent to Tramadol that leads him to hallucination and delerium. His bladder cannot hold lots of urine due to bladder inflammation. We already did what the doctors says but still no improvement. The problem still the same and my father is still suffering from his condition. Please help us and give us recommendation.

The problem that you describe is a urological condition.  I am a nephrologist.  I have no expertise in diseases of the bladder and urinary tract.  I suggest that you discuss this with a urologist. For more information on Uti’s click here:

Posted in Ask the Doctor, Blood/Urine Testing For Kidney Disease, Chronic Kidney Disease, Kidney-Related Health Questions, Laboratory Testing, Treatments, Urinary Tract Infection/Pyelonephritis, Urological Issues

Hi Doctor, I’m a 27 year old, Korean, healthy, female. My blood pressure is always very low and I’ve maintained good health for the most part. For more than a year, I have experienced kidney pain and tenderness the night of and day after I drink alcohol. I’ve always thought it was nothing to worry about since I had ingested alcohol and thought this was my body’s normal reaction. There was a time when I didn’t have these symptoms, but it’s been a long time. Recently, I went to my PCP because my kidney pain lasted a few days after I had drank alcohol. My doctor did a UA and my results came back as follows: GLUCOSE, UA Negative mg/dL; KETONES, UA 80 (2+) mg/dL; SPECIFIC GRAVITY, UA 1.027; UA HGB 0.03 (1+) mg/dL; PH, UA 5.0; PROTEIN, UA 30 (1+) mg/dL; NITRITE, UA Negative; LEUKOCYTE ESTERASE, UA Positive; UROBILINOGEN, UA, QL Negative; BILIRUBIN, UA Negative…. WBC’S, UA/HPF 6-10 HPF; RBC, URINE HPF 4-10 HPF; MUCOUS, UR SED, QL, AUTOMATED COUNT Present HPF; HYALINE CASTS, URINE SEDIMENT, AUTOMATED COUNT, QUAL 5-10 LPF. In July, my GFR was 86 mL and my Vitamin D levels were 16ng/mL. I have not repeated a blood test since July. When I spoke with my doctor regarding my results, she stated she ruled out a UTI and a Kidney Infection. She referred me to a Urologist and Radiology for an ultrasound. I have had a kidney infection previously in 2012. I can’t get into my urologist until April, so naturally – I’m scared. Do these results lean toward a kidney stone being present? Could it have been present for over a year and only agitate when I drink alcohol? Or do these seem to point toward diseased kidneys? I’ve lost about 12 pounds in the last couple months (108lbs, 5’3″) and have (in the last week) a decreased appetite. In the last four days, I have been experiencing a low grade fever and chronic, dull pain/heaviness in my kidneys. Since I have experienced a kidney infection before, I am reluctant to go to the ER to see a specialist sooner. Are these symptoms something I need to address sooner than April?

I am unable to provide a specific diagnosis based on the information that you provide.  I am a nephrologist and I cannot make a diagnosis of kidney disease based on the information that you describe.  I agree that you should … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney Stones, Kidney-Related Health Questions, Laboratory Testing, Symptoms and Side Effects, Treatments, Urinary Tract Infection/Pyelonephritis, Urological Issues