Category Archives: 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

I was just dx with CKD and calculus kidneys my lower back hurts all the time. Pain in the right side in my lower back and lower left in the back. Is this normal and of course I have fatigue and will go to my nephrologist on April 4. I hurt whether I have a kidney infection.

If there is a stone (calculus) in your kidney, then this must be evaluated and treated by a urologist, not a nephrologist.  I suggest consultation with a urologist. For more information on kidney stones click here:

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

A week ago I went to the ER with what I thought was a kidney stone attack. I’m 80 yrs old and in general good health. Some years ago I had an attack and had one or two stones removed from a kidney. In the ER they did a scan to show to their Urologist. The scan showed I had a very large cyst on my right kidney and that cyst, depending upon scan view “slice” showed it surrounding a stone. The left kidney was free of any shown cysts and normal. The scan showed the cyst to be round and symmetrical, not tumor like. At the moment I’m awaiting a decision from the Urologist re how to proceed. The Urologist told me initially upon looking at the scan, “it looks like a very difficult case”. The Urologist has since taken ultrasound views of the affected kidney area supposedly to show and review with a Radiologist. From what I’m thinking, the treatment plan might be for the Radiologist to aspirate the cyst then the Urologist to “roof” the cyst and then go in and remove the stone. After the initial stone, intense pain, I took a couple of pain killers and the severe pain subsided and it’s been “low grade” ever since. Sitting or bending certain ways can bring on the pain, but otherwise it’s continually like a mild tooth ache. It seems to be taking time for my Urologist to come up with a treatment plan and date for a procedure. Is the treatment for my condition one that requires any experience/training beyond what a typical Urologist and Radiologist would be doing on a regular basis. Are there any Medicare _+ Medigap insurance issues covering such a procedure.

I am a nephrologist and have no surgical expertise.  A urologist is a surgeon and has expertise in the surgical treatment of kidney stones and complex cysts of the kidney.  I suggest that you continue to consult with your urologist. … Continue reading

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

I am writing on behalf of a friend from Turkmenistan. My friend is studying in China and does not know much English, which complicates things. But from what I can gather, his father is having a problem with kidney stones. His father has only one kidney, and last year he had an operation to remove his kidney stones. However, according to my friend, the operation was not that successful because many kidney stones still remain. His father does not want an operation, but wants to know if there is medicine or any other treatment he can have to get rid of the kidney stones. According to my friend, the type of kidney stones his father has are called “korall.” He sent me some photos, and it looks like this many has had a LOT of kidney stones removed already. Do you have any advice for my friend and his father, or do you have any suggestions as to what my next step should be in finding an answer for him?

I am not familiar with “korall” stones.  The problem that you pose is a urological problem.  Consultation with a urologist, who is a surgeon, would be most appropriate. For more information on kidney stones click here:    

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

5 months back, I had a kidney stone operation of the right kidney and I find that right kidney is functioning 9 ℅ and left kidney is functioning 42℅. Now after 5 months, I have very bad pains in my right kidney seems very heavy. Bad smell in the urine. What should I do? I have already gone thru surgery twice of my right kidney. Please help.

The problem that you describe is a urological problem and I am a nephrologist.  I do not perform surgery.  You should consult with your urologist. For more information on kidney stones click here:

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

Please help me I have medullary sponge kidney. I am in pain everyday. I have kidney stones in both kidneys small ones and big ones 7, 8, 9 mm big. I have a urologist, but he won’t give me nothing for pain. What can I do? Please help. I can’t take this pain anymore.

Medullary Sponge Kidney (MSK) is a rare kidney disease that causes damage to the collecting tubules of the kidney and calcium is known to build up within these tubules.  This can result in the passage of multiple kidney stones.  Treatment … Continue reading

Posted in Ask the Doctor, Chronic Kidney Disease, Kidney-Related Health Questions, Laboratory Testing, Medullary Sponge Kidney, Treatments, Urological Issues

My father-in-law (age 76) was just told he has an 11cm growth on one of his kidneys. After blood work and a CT scan, the doctors (Primary and Urologist) are telling him he has fluid around that kidney. Given my father-in-law’s prior heart attack (20 yrs. ago) and mini strokes (4 yrs ago), history of high blood pressure & high cholesterol (both controlled with meds), and long-term Cumadin use, his PCP has ordered a repeat scan of his heart (last scan was in June ’16). I’ve never heard of this type of issue (fluid around the kidneys). Could you please tell me common causes. My husband and his two siblings live away from their parents, so none of us are able to attend doctor’s visits to ask questions. We are all concerned and want to be informed/educated.

The problem that you describe is a urological problem.  I am a nephrologist and do not have any expertise in this area.  A growth with fluid around it is not something I am familiar with.  I suggest that you discuss … Continue reading

Posted in Ask the Doctor, Kidney-Related Health Questions, Laboratory Testing, Nephrologist, Symptoms and Side Effects, Urological Issues