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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Ultrasound For Abdomen Done. Do I Have To Go Under Open Surgerry Or It Will Be Cured By Laser?

Hello there, I just had an ultrasound for my abdomen and Doctor s impression is this. Left Kidney is grossly hydronephrotic shows thinned out cortex and measures 20 X 14 cms. Multiple calculi measuring 14 to 18mm seen in the mid and lower calyceal region of the left Kidney. Large Calculus measuring 20mm seen in the left PUJ. Do I have to go under open surgerry or it will cured by laser? Thank you and hoping for the speed respond. Omel
Sat, 16 Jun 2012
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Internal Medicine Specialist,  's  Response
Hello.Thanks for the question.I am really sorry to hear about your ultrasound report.From ultrasound details it is clear that it has been a long term issue, even if there were no or minimal symptoms .Since kidney has significantly enlarged in sized and even cortex has thinned, at the moment kidney must have lost most of its function.Kidney is normal 10 x 5 cms. Thinning of cortex occurs only in long term obstruction.I think you should get a IVP done to know if there is any residual kidney function left.If there is function left and since there are multiple calculi I would be more inclined towards surgery.Hope this answers your question.Thank you.
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General & Family Physician,  Dr. Shanthi E 's  Response

Hi Omel,

I understand your concern.

A large calculus measuring 20mm in the left PUJ is definitely an indication for PCNL (Percutanous Nephrolithotomy. If the PCNL cannot be done, then you may have to go in for an open surgery.

The multiple calculi measuring 14 to 18mm in the mid and lower calyceal region can be removed using Ureteroscopic retrieval of the stone or the basketing technique. However, the calculi are quite large for this also.

So, my opinion is that laser may not be effective in you. You may require an open surgery for the stones.

The decision lies with the operating urologist and the patient.

Hope I have been of help to you.

Regards,
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Ultrasound For Abdomen Done. Do I Have To Go Under Open Surgerry Or It Will Be Cured By Laser?

Hello.Thanks for the question.I am really sorry to hear about your ultrasound report.From ultrasound details it is clear that it has been a long term issue, even if there were no or minimal symptoms .Since kidney has significantly enlarged in sized and even cortex has thinned, at the moment kidney must have lost most of its function.Kidney is normal 10 x 5 cms. Thinning of cortex occurs only in long term obstruction.I think you should get a IVP done to know if there is any residual kidney function left.If there is function left and since there are multiple calculi I would be more inclined towards surgery.Hope this answers your question.Thank you.