Category Archives: Urological Issues

I’ve some indications from bloodwork and urinalysis that something may not be right with my kidneys. I go for a retroperitoneal ultrasound and here are the exact words of the radiologist: Right kidney measures 11.4 x 5.9 x 5.6 cm. Left kidney measures 10 x 5.4 x 5.8 cm. Both kidneys are mildly atrophic with cortical thinning. No hydronephrosis or obstructing stone. A hypoechoic structure in the cortex of the right kidney midpole measures 1.5 x 1.4 x 1.7 cm, mildly complex. Bladder is distended and unremarkable. Impression: Mild medical renal disease. Complex cyst versus hypoechoic mass in the right kidney renal cortex. This indicated, follow-up contrast-enhanced CT or MRI is recommended for further evaluation. Then I go for an abdominal MRI wwo contrast and the doctor who ordered it writes back (exact words): Good news: your most recent MRI of the abdomen/pelvis did not show any disease of your kidneys. Your liver is fatty. Does that mean the ultrasound found something that wasn’t really there was nothing there or that the MRI just showed that what is there is nothing to worry about? Thank You.

An ultrasound examination is generally better at detecting cysts than a Magnetic Resonance Imaging (MRI) scan. A urologist is an expert in the evaluation and treatment of complex cysts of the kidney. I am a nephrologist and cannot comment about … Continue reading

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

I have been having pain in my back and right side off and on for a few years. I was diagnosed with CKD. I recently had an ultrasound that shows significant cystic changes in my right kidney. My renal size is 14.4 cm in length and there is a dominant lower pole renal cyst demonstrated in the inferior right kidney measuring greater than 5 cm. There is a small exophytic component to this cyst. I had a previous cat scan w/out contrast that documented non-obstructing calculi a couple months earlier. On this Ultrasound there is significant ectasia at the renal pelvis, there is a superior pole cyst measuring 4.7 cm. The collecting system appears to be less than 10 mm in caliber. There is suggestion of very mild pelvocaliectasis. The left kidney similarly demonstrates mild pelvocaliectasis. This kidney has no significant solid of cystic abnormality in the left renal parenchyma. The left kidney measures 13.4 cm. The bladder looks normal. A) What does all this exactly mean? B) Do I need surgery? C) I have a niece with PKD that we don’t know if it came from my side of the family or not, can it be PKD? D) What type of intervention is normally done if any?

From your description, I do not believe this represents polycystic kidney disease (PCKD). The number of cysts seen in PCKD is often too numerous to count and it appears you have a countable number of cysts on your right kidney … Continue reading

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

I have a kidney stone. I was having back pain on my left side in June went to my doctor. They took a urine sample you could see the stuff floating in it. They put me on antibiotics, then told me to stop taking them as it’s not a UTI. This past month my pain got worse went up my back couldn’t get comfortable sitting or sleeping. Pain in both shoulders and my neck. I went back to the doctor they did more tests and urine sample, still full of stuff and this time had some blood. Put me back on antibiotics. I was told to stop them again as it’s not a UTI. I am starting to feel better. They did a CT. I still have a stone in my kidney. What can be causing all of my problems?

I am not able to make a specific diagnosis based on the information that you present. A kidney stone can cause pain and blood in the urine. I suggest that you consult with your primary care physician and have further … Continue reading

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

I had over a dozen UTIs from 2011-2013, did a bladder wash with Elmiron, was diagnosed with Mild Interstitial Cystitis, and have had 5 diagnosed kidney infections in less than 2 years, from late 2016 to now. I’ve noticed that with the UTIs, I have painful urination, but with the kidney infections I only feel the pain at my kidneys. I don’t have most of the symptoms for kidney infection (fever, chills, frequent urination, burning while urinating, nausea, cloudy urine), and when a urinalysis is conducted, it’s always clear. But the urine culture always comes back positive. How my infections manifest has changed, but I’m not sure whether to be concerned about how they’re changing. Do you have any insight? Thank you.

The problem that you describe is a bladder problem. I am a nephrologist and do not have any expertise in bladder disease. A urologist is a surgeon and has expertise with bladder diseases and treatment. I suggest that you consult … Continue reading

Posted in Ask the Doctor, Urinary Tract Infection/Pyelonephritis, Urological Issues

I am 35 year old. My left kidney GFR 9 with scar and non-function and 5 mm stone and UTI infection. My right kidney GFR 61 normal function of kidney. Doctor say left kidney removal. What do you recommend for me? All blood reports are normal. Please.

I am a nephrologist and not a surgeon. A urologist is a surgeon and would the physician with expertise about performing surgery for an infected non-functioning kidney. I suggest that you consult with a urologist.

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

Hello doctor. I am from India. I have severe back pain on right side. When I got scanned for CT contrast the report says I have mild renal hydrouretus nephrosis and tiny umbilical hernia. My past history was two years back I have got diagnosed for kidney stones in right side. Only with lithotripsy for one year I was fine, but after a year I started having pointed pain on right side of my back but now it has spread and it is very severe now. I consulted both nephrologist & urologist but they don’t have any suggestion for me. Just they have prescribed pain killers. One more important thing, I have got strong heredity of kidney disease. All my siblings have got this disease like polycystic, CKD, etc. I am very tense and feeling very depressed what to do since the doctors are not suggesting me any treatment. Let me know if I can send reports through mail. Please help me out doctor.

I am unable to accept any reports or medical studies with this blog. I am unable to provide diagnosis or treatment without performing a complete history and physical examination. The computerized tomogram (CT) scan that you had, should have diagnosed … Continue reading

Posted in Ask the Doctor, Kidney Stones, Nephrologist, Polycystic Kidney Disease, Urological Issues

I’m a 41 year old woman, had my kidney transplant 5 years. I’ve been getting a lot of UTI’s, 3 plus a year. Is any preventative measure I can take to stop? Urologist is leaning towards a stone in native kidney harboring infection. He wants to remove it but I’m scared. And want to make sure it’s the right thing to do. Any insight would help.

If the focus of infection is in a stone, it will not be possible to eradicate the infection with antibiotics alone. An infected stone must usually be removed. I am a nephrologist and not a surgeon, so I am do … Continue reading

Posted in Ask the Doctor, Kidney Stones, Kidney-Related Health Questions, Urinary Tract Infection/Pyelonephritis, Urological Issues

Hello sir, I am from India. My blood test results of kidney is 1.5. So doctor advised me for sonogram. In sonogramn, my kidneys are normal but in right kidney 4 mm kidney stone found. Sir, please tell me this normal or I need any treatment.

I am unable to make a specific diagnosis based on the information that you present. The stone in your kidney is relatively small. Stones in the kidney are usually evaluated by a urologist. I am a nephrologist and do not … Continue reading

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

Hi Doctor, I am a 40year old male based in New Delhi. In August last year, I had UTI. On getting the USG, there were 2 observations. 1. The prostate was enlarged (40cc) 2. I have one large ( 12.3 *6.4cm) and one small (6.1 * 3.9cm) kidney. The USG was unable to conirm whether the other small kidney had blood supply or is working. (This was the first USG I did in my life). The repeat USG after taking antibiotics has prostate @28cc. My flow is still slow and I feel I have not emptied bladder fully. So doctor prescribed Alfuzosin 10mg OD. What I wanted to seek your opinion on is: a) Can I get a scan like DMSA to know the kidney function? Since they use dye is it safe? b) Any precautions I have to take? c) Is it possible that the kidney shrank and that’s why I got UTI? Is there a way to confirm this?

I am a nephrologist and I have no expertise in the treatment of prostate or bladder disease. A urologist is a surgeon and has expertise in the management of prostate and bladder disease. A urologist is also an expert in … Continue reading

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

Please. I am 78 year old female. I am diagnosed with small kidney size with thin cortex and increased in parenchymal echogenicity with poor cortical differentiation with two large stone and cysts. My creatinine and urea and microalbuminuria are normal. My pH of urine was 5 so l take URO3 (potassium bicarbonate citrate) and my pH return to 6.

I would also recommend that follow the DASH diet. You should limit your salt intake to less than 2300 milligrams of sodium per day. You can review the DASH diet at: https://www.nhlbi.nih.gov/health-topics/dash-eating-plan For treatment of the stones in your kidneys, you … Continue reading

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