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What Causes Hematuria After Having Stents In Renal Units?

Posted on Mon, 2 Mar 2015

Question: My mother has kidney stents. She has had significant blood in her urine which is lowering her hemoglobin. She has a sarcoma tumor attaching to one of her stents likely causing the bleeding. How do we stop the bleeding?

Answered by Dr. Dr. P. T. Patil (7 hours later)

Brief Answer:
Please provide few more details.

Detailed Answer:
Hello
Thanks for your query,based on the facts that you have posted it appears that your mother has gross Hematuria after putting the stents in both renal units..

I shall be happy if you can post me few more details to help me in making comments on your problem.
1) Where is the Sarcoma? is it in the kidney or retro peritoneum? or bladder?
2) Has she undergone any surgery for sarcoma?
3) What is reason for putting the stents in kidney ?

Please do write about reports and findings of all the tests and investigations she has undergone so that I can make precise comments on her present problem of Hematuria.

Hope I have answered your query ,please feel free to ask if you have more questions I shall be happy to help you
Thanks and Regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Dr. P. T. Patil (20 minutes later)

The cancer is not in her bladder or kidney. The tumor is next to her left kidney, pushing on her stent. Her kidney function is fine now, but was compromised because of a previously removed sarcoma tumor which altered function. Stents are helping the flow of urine through kidneys. As stated, she has bloody urine which is affecting the hemoglobin. Her oncologist seems to be waiting...she will need another transfusion soon, as she is urinating frequently. Please advise me what kind of doctor to see and what kind of test to check on bleeding. Bleeding not indicated in catscan or ultrasound. Can this be cauterized? Can the stent be exchanged if the tumor is touching it? Thank you.

Answered by Dr. Dr. P. T. Patil (51 minutes later)

Brief Answer:
She has retro peritoneal sarcoma.

Detailed Answer:
Hello
Thanks for feedback.
Based on gross information that you have posted I would summarize her problem as follow .
Your mother had Sarcoma in the retro peritoneum close to her kidney and pressing over both the ureters making it mandatory to put the stents in both the ureters so that urine can flow down in bladder and help to release the pressure on kidneys and improve kidney function.

Sarcoma is very fast growing tumor and it is likely that it has either infiltrated in kidney or ureter causing bleeding (Hematuria). Sometimes stent also cause infection and give rise to hematuria but never such a gross hematuria to necessitate blood transfusion.

In a given situation, I would like to suggest treatment in following direction.
1) Repeat C.T scan to see whether sarcoma has recurred again
2) Urine routine and Urine culture
3) If Kidney function is normal I.V.P will help to delineate urinary system and will reveal whether ureters are infiltrated or not..

You need to consult qualified Urologist for further evaluation and treatment in joint consultation with your Oncologist.

Thanks and Regards.
Dr.Patil.

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Above answer was peer-reviewed by : Dr. Ashwin Bhandari