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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Remedy For Almost Worn Out Kidney With PUJ Block

SIR/MADAM, I AM 41 YEARS OLD & DURING PREVENTIVE HEALTH CHECK UP IT IS FOUND THAT THERE IS A PUJ BLOCK TO MY LEFT KIDNEY. I HAD DONE SONOGRAPHY, BLOOD TEST & ALSO TESTED INJECTING WITH RADIOACTIVE SUBSTANCE. SUGAR & OTHER LEVELS ARE OK. BUT TESTS SUGGESTS THAN LEFT KIDNEY IS ALMOST WEAR OUT & IT FUNCTION 8% WHILE RIGHT ONE IS FUNCTIONING @ 92%. DOCTORS R SUGGESTING THAT THEY WILL PERFORM OPENSURGERY (PYLOPLASTY) & IF FOUND THAT KIDNEY IS DAMAGED COMPLETELY, THEY WILL REMOVE IT.
THERE IS VEY SMALL PAIN RIGHT NOW. SOME DOCTORS, PARTICULARLY AYRUVEDIC ONE SAYS THAT IF THERE IS NO PAIN, & PUJ BLOCK IS FROM CHILDHOOD, RIGHT KIDNY HAD TAKEN COMPLETE LOAD, HENCE DO NOT OPERATE UNTILL THERE IS SEVERE PAIN. PLEASE SUGGEST WHAT TO DO?
Tue, 13 Sep 2016
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Urologist 's  Response
Hi
I understand your concern.

PUJ obstruction can sometimes damage the kidney without producing symptoms as is the case with you. I hope you have had CT scan of your kidney and the renogram is a DMSA scan and not EC or MAG3 or DTPA renogram as DMSA scan is better at estimating function of kidney.

If the function is below 15% on DMSA renogram and there is very little cortex left in the kidney on CT scan then the only option is to remove the kidney. I would advice against not doing an operation as if infection happens then it can be life threatening and I have seen patients becoming very sick with in a matter of minutes.

I will also not advice pyeloplasty in such a scenario(unless there is good cortex in the kidney) as it will almost always fail and you might need to have the kidney removed in the future in another operation.
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Suggest Remedy For Almost Worn Out Kidney With PUJ Block

Hi I understand your concern. PUJ obstruction can sometimes damage the kidney without producing symptoms as is the case with you. I hope you have had CT scan of your kidney and the renogram is a DMSA scan and not EC or MAG3 or DTPA renogram as DMSA scan is better at estimating function of kidney. If the function is below 15% on DMSA renogram and there is very little cortex left in the kidney on CT scan then the only option is to remove the kidney. I would advice against not doing an operation as if infection happens then it can be life threatening and I have seen patients becoming very sick with in a matter of minutes. I will also not advice pyeloplasty in such a scenario(unless there is good cortex in the kidney) as it will almost always fail and you might need to have the kidney removed in the future in another operation.