Category Archives: Urological Issues

This is the result of a CT UROGRAM done in 10/2012. There are bilateral renal calculi. Specifically, there is an approximately 9 x 5 mm right upper pole calculus with focal prominent thinning overlying cortex consistent with sequelae of prior infection. There is an approximately 3 mm calculus centrally mid to upper pole left kidney. IMPRESSION: BILATERAL RENAL CALCULI, LARGER ON THE RIGHT WITH THINNING OVERLYING CORTEX CONSISTENT WITH SEQUELAE OF PRIOR INFECTION. NO RENAL MASS OR OBSTRUCTIVE UROPATHY. I’ve had shockwave done twice, once on the right in 2012 and once on the left last year. Recently I have been seeing my primary because of a UTI. I had an urinalysis done in office with the following results; Component Your Value Glucose neg mg/dL Bilirubin moderate Ketones trace mg/dL Spec Gravity 1.025 Blood large pH 5.5 Protein >=300 mg/dl mg/dL Urobilinogen 2.0 E. u> /dl EU/dL Nitrite positive Leuk. Esterase large Color red Pale yellow Appearance other, on period All of my pain is on the right side. I am nauseous, occasional vomiting, loss of appetite, and difficulty urinating. At times it is difficult to start a stream and at times only a drizzle comes out. The CT scan I had on 07/07/2017 did not show a stone on the right side. I have scarring in my right kidney due to a prior infection. So I am wondering is the stone that was originally there, able to hide behind the scarring and not be seen on CT? How does a 9 mm stone just disappear yet the 3mm one in the other kidney still be there? and if there is no stone, then why the crazy numbers on the urinalysis? Any thoughts would be helpful.

The problem that you present is a urological problem.  I am a nephrologist and have no expertise in the surgical management of kidney stone disease.  You need to consult with a urologist.  A urologist is a surgeon who deals with … Continue reading

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

I am patient with left kidney Bosniak III, Hydronephrosis IV both kidneys, multiple stones both kidneys. A Double J stent incarcerated on left kidney. Could not remove it at all. Left kidney functioning 50%, right one 42%. Doctors in El Salvador want to remove left kidney, total removal. Please a second opinion, may God bless you. I could attend a consultation wherever it is available in TX.

The question that you pose is a urological question and must be addressed to a urologist.  I am a nephrologist and I have no surgical expertise.  Hence, I suggest that you ask your primary care physician (PCP) for referral to … Continue reading

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

I have had uric acid kidney stones for over a year. I get them every month. They pass on their own. I go to the hospital for pain management if I have to. Recent blood test from hospital on June 10 showed chronic kidney disease stage 3. The creatine 1.33 gfr 46. CT tests showed multiple stones in left ureter. I am female 53 years old. Will I live long enough to see my 12 year old become an adult? My doctors never told me this. I never knew this could happen with just a year of stones. Could it go back to normal once stones pass?

Kidney stones are usually treated by a Urologist.  I am a Nephrologist and treat patients to prevent kidney stones.  I suggest that you consult with a Urologist and determine the best course of treatment for your existing stones.  You should … Continue reading

Posted in Ask the Doctor, Nephrologist, Urological Issues

How do doctors figure out which kidney is bad?

If chronic kidney disease (CKD) is present, then both kidneys are involved.  Certain cystic diseases and urological disease may effect only one kidney, but this can be determined with an ultrasound examination of the kidney.  Most other forms of CKD … Continue reading

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

I am 17 years old. My left kidney is enlarged with gross hydronephrosis and thinned our renal cortex. Right kidney is normal from recent report. I had a surgery when I was 6 years old and again pyeloplasty was done when I was 13 years old. So how can it be treated?

The question that you ask is a urological question.  I am a nephrologist and I have no expertise in surgery or urology.  You should ask the question of a urologist. For more information on Hydronephrosis click here:

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

I have been advised that I need to have a “Ureteroscopic extraction of calculus of ureter” to remove a 9mm stone that is half way between kidney and bladder. What are the complications of this and what is the anticipated recovery time. I am just trying to determine whether to wait for the proceedure until after I come back from holiday or risk having it done prior to departure. I am due to have the procedure on Wednesday and fly three days later. I hope you can help give me some information to help me make an informed decision.

The question that you ask is a urological question.  I am a nephrologist and I have no expertise in urology or surgery.  You should discuss this with the urologist who is planning on performing the surgery.  

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

I’m a 66yo female with hematuria discovered in my urine 1 1/2yrs ago. Referred to urologist and have had pretty much all testing to determine the cause to no avail. Saw my urologist for my 6 month checkup and said “no more Cat-Scans” to which she agreed as nothing has showed up and after 7, I felt I didn’t want more unnecessary radiation. She wanted to do one more test which if it came back normal I wouldn’t see her again for another year. The test was a hematuria study to determine if the blood was coming from the upper of lower tract. Let me also say it’s only a very small amount of blood showing up and only on a dipstick or urinalysis. Not visable in my urine. Hematuria study came back that the blood is coming from my kidneys with the dx: “Dysmorphic erythrocytes indicating severe glomerular and/or renal tubular bleeding”. Now I just finished a 24hr urine collection test along with blood work to check for protein and a few other things. I haven’t got the results of this yet. My mother died of kidney cancer at age 66, her mother of some type of leukemia at age 68 and I had thyroid cancer at age 27. If this is kidney damage, should I be seeing a nephrologist and would the likely next step be a kidney biopsy. I feel like this might have been caused by high blood pressure I ignored for several years, only starting on medication a few months ago. To say I’m more then a little stressed out waiting for the results is an understatement, but have the feeling all I’m going to hear is “let’s do another test or procedure” so still will have no answers. Any insight would be appreciated.

Yes, the evaluation of isolated hematuria (blood in the urine) is first to see a urologist and make sure it is not coming from the lower urinary tract.  If nothing is found, then the next decision whether the red blood … Continue reading

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

I had a pyeloplasty in 2006 due to a ureteral pelvic junction (UPJ) obstruction. I am now having pain in my left kidney going down to my groin. I am slightly nauseous. There is no pain while urinating, urine is clear and I do not have a fever. Can the pyeloplasty fail? Or could it be a stone or infection or anything else? I appreciate any advice.

The question that you ask is a urological question.  I am a nephrologist and do not perform surgery and do not deal with diseases of the lower urinary tract.  I suggest that you consult with your primary care physician (PCP) … Continue reading

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

Hi doctor, I am 22 year old. I have an endstage renal disease secondary to vesicoureteric reflux disease with bilateral hydronephrosis with frequent urinary tract infection. I was on CIC and I was labeled as Hinman syndrome. I underwent bladder augmentation in June 2012 with ileocystoplasty and I was cleared for transplant by Urology. I started dialysis in December 2012, through the left AV fistula. I am having dialysis 3 times per week for 4 hours and I tolerate dialysis well. Currently, I am making minimal amount of urine only few drops on nondialysis and continues on bladder irrigation per urethra. No history of blood transfusion and no history of recent urinary tract infection. Regarding kidney transplantation, should the old kidney be removed first in a separate procedure? Or should it be removed and the new one be transplanted in the same procedure? and is it possible to stop doing CIC postoperatively? More details about the presenting complaint: I am a product of cesarean section as I was preterm with prolonged incubation for 2 weeks and neonatal ICU. At the age of 5 years, I was presented to Pediatric Urology Department with chronic urine retention and chronic constipation. Investigation at that time showed a creatinine of 60 and ultrasound showed severe bilateral hydronephrosis and VCUG showed vesicoureteric reflux. I was treated with a urethral catheter to evacuate the bladder, and I was labeled as Hinman syndrome Current medications: 1. Calcium carbonate 600 mg t.i.d. 2. Renagel 800 mg t.i.d. 3. Mapa (Acetaminophen) 325 g tablet Past medications of the same issue: SPS (Sodium Polystyrene Sulfonate) Suspension, Rocaltrol (Cacitirol), Nephro-vite (Multivitamine: Vit B Complex, Vit C and FA), Sodium CL, Zinnate (Cefuroxime), Aranse (Darbepoetin), FeroSul (Ferrous Sulfate) 65 mg elemental Iron, Amlor (Amlodipine). Klavox (Amoxicillin-Add to dictionary), Cipromax (Ciprofloxacin), Normoten (Atenolol), Add to dictionary (Calcitriol). Lab tests performed: 1. HLA Antibody identification: PRA I Screen – Luminex ID: Positive Class I PRA II Screen Luminex ID: Negative Class II Luminex Solid Phase Assay 2. CBC: Hematocrit: 0.356 L/L Hemoglobine: 116 g/L MCHC: 326 g/L MCV: 98.3 fL MPV: 10.4 fL Nucleated RBC Absolute Auto: 0.01 10`9/L Platelet: 220 10`9/L RBC: 3.62 10`12/L RDW: 14.3% WBC: 5.75 10`9/L 3. Chemistry: Urea: 12.0 mmol/L e-GFR: 6 mL/min/1.73`2 PO4: 2.30 mmol/L K: 5.4 mmol/L creatinine: 985 umol/L Cl: 94 mmol/L CO2: 33.0 mmol/L ALT: 7.4 U/L The

The decision to remove your old kidneys must be made by a urologist.  I am a nephrologist and do not perform surgery.  A urologist is a surgeon and has expertise in regards to urinary tract disease and bladder disease that … Continue reading

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

My 13.5 year old son with single kidney status has serum creatinine of 1.0 mg/dl. All electrolytes, urea and uric acid values are within the normal range. There is no blood or protein in the urine. Can you give your opinion on this? PUV done on 3rd day of birth. Born with hydronephrosis.

The problem that you pose is a urological problem.  I am a nephrologist and do not see children.  I suggest that you consult with a urologist.  

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