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What Should I Do About Reduction In The Function Of The Kidney On The Affected Side By 5% After A Pyelopasty?
Question: i had a pyeloplasty when I was 17 for upj obstruction, 17 years later i had a repeat pyelo 7 months ago. since the surgery function went from 42 to 37 on left
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My renal scan also said diminished cortical uptake that%E2%80%99s why am guessing it is this also do you think I would need another pyeloplasty is it OK to do a balloon dilation after all of these issues
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My renal scan also said diminished cortical uptake that%E2%80%99s why am guessing it is this also do you think I would need another pyeloplasty is it OK to do a balloon dilation after all of these issues
Brief Answer:
Could be due to Stenosis at the site of anastomosis
Detailed Answer:
Hello,
Based on the facts that you have posted you have undergone Pyeloplasty at the age of 17 years and repeat pyeloplasty 7 months back and have revealed the function of the kidney on affected side to have gone down by 5%.
This is most likely to be due to stenosis at the site of anastomosis resulting into obstruction to the drainage of urine from that kidney resulting into back pressure changes in the kidney.
You need to consult the operating Urologist for revaluation and get recent Renal Scan done to explore need for redo surgery again.
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
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Brief Answer:
Will be decided by treating Urologist
Detailed Answer:
Hello,
The need for repeat surgery will be decided by treating Urologist based on the comparison between previous and present status of Renal function whether there is significant reduction in renal function and thickness of renal cortex.
Thanks and Regards.
Dr Patil.
Could be due to Stenosis at the site of anastomosis
Detailed Answer:
Hello,
Based on the facts that you have posted you have undergone Pyeloplasty at the age of 17 years and repeat pyeloplasty 7 months back and have revealed the function of the kidney on affected side to have gone down by 5%.
This is most likely to be due to stenosis at the site of anastomosis resulting into obstruction to the drainage of urine from that kidney resulting into back pressure changes in the kidney.
You need to consult the operating Urologist for revaluation and get recent Renal Scan done to explore need for redo surgery again.
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
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Brief Answer:
Will be decided by treating Urologist
Detailed Answer:
Hello,
The need for repeat surgery will be decided by treating Urologist based on the comparison between previous and present status of Renal function whether there is significant reduction in renal function and thickness of renal cortex.
Thanks and Regards.
Dr Patil.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
What would be the reason to either do renal angioplasty versus pyeloplasty? Angio just to avoid cutting the ureter again? Is there a high success rate on balloon dilation versus pyeloplasty?
Brief Answer:
Results of Balloon dilatation are not longer lasting
Detailed Answer:
Hello,
Results of Balloon dilation are very short lasting and is not effective in patients who have already undergone surgery .Renal cortex is the main functional unit of kidney where urine is produced .The diminished cortical function in such cases is due to chronic back pressure changes (Thinning of cortex ) due obstruction to free flow of urine from kidney down into ureter .
More over the renal paranchyma once damaged does not regenerate .
Thanks and Regards,
Dr. Patil
Results of Balloon dilatation are not longer lasting
Detailed Answer:
Hello,
Results of Balloon dilation are very short lasting and is not effective in patients who have already undergone surgery .Renal cortex is the main functional unit of kidney where urine is produced .The diminished cortical function in such cases is due to chronic back pressure changes (Thinning of cortex ) due obstruction to free flow of urine from kidney down into ureter .
More over the renal paranchyma once damaged does not regenerate .
Thanks and Regards,
Dr. Patil
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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