hydronephrosis and renal pelvic obstruction (puj)
| Discussion in 'All Categories' started by majid ur rahman - Sep 18th, 2011 12:10 am. | |
majid ur rahman
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we are in saudi arabia last 8-9years. my husband has dialated pelvis with renal pelvic obstruction (puj). he dont know from how many years he had this problm.first time in 2007 when he did scan for kidney stone then he know his stone is big 2.7cm stone in left kidney so doctors sugest him do ivu or ivp.this x rays shows puj obstruction and doctors says his left kidney swellon also due big stone. so doctur suggest him surgery ,doctor explain the procedure of sugery....firt doctor remove the stone then doctor clear the obstruction (pyeloplasty) in same sugery. but when he go this operation,before doing him pre-operation procedure ,specialist doctors present that time and see scan reports X-rays and ivp and told me we checkhed allreports again and again and take a decision first we doing endoscopy for stone removing,and then we keep a stent in ureter may be clear obstruction and also said obstruction due to swellon kidney and hydronephrosis,so may be clear after endoscopy. finally endoscopy done and after two weaks remove stent and said all is ok drink plenty of water may be problem never come again.if problem again then come other wise all is ok no need to surgery. 2..After two to two and half yers he had also pain again we do scan ,x-rays and ivp.the problem is same instead of big stone, small two three stone in same left kidney and same hydronephrosis and puj obstructions, this time smaal stone in ureter also seen. now we come india(in last year oct 2010) and consult an indian urologist surgeon,he seen all reports and this urologist also suggest pyeloplasty. we prepare for an open surgery.and done all pre-operative test and admit in hyderabad nursing home on 2nd Oct 2010(last year) at hyderabad where the doctor doing operation because we cant offord big hospital charges. here same thing again happened ,doctor didnot done pyeloplasty instead of this doctor said we done endopyelotomy or other term icant read what term is. and tell procedure...we see your husband's report before sugery many times and we see puj obsruction is not completely obstruction,so we clear obstruction by the way of urethera by laser there is leasion (lesion what is i dont know) type thing,we clear it and break all stones and remved and put stent in ureter. after two weeks doctor remove stent .and give medicinefor three months for donot form stone again said drink water and stop taking red meats, curd (instead of curd take butter milk,),dont eat ghee and sweets that madeup of milk and ghee. 3....Now in july my feel pain and consult to doctor says do urine analysis and doctor see report and said infection in urine and give medicine for it. After one month(in 3rd sep. 2011) my husban feel pain go and consult to doctor gave him pain killar he find stone in urine after four five hours . now doctor sugget him do scan .in scan same thing doctor see and said hydronephrosis and no stone found. he sugest for ivu or ivp. Ivp report shows-- 1...gross hydronephsis on the left side with markedly dialated funnal shaped pelvis of the left kidney showing intense narrowing at the left UPJ. Thin ureter opcified in the upper half . |
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re: hydronephrosis and renal pelvic obstruction (puj)
by Dr Sadhana -
Sep 19th, 2011
6:54 pm
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Dr Sadhana
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Dear Majid Ur Rahman We are deeply concern with the problem which you are facing due to your husband's recurrent PUJ obstruction. A blockage of the flow of urine from part of the kidney known as the renal pelvis to the ureter, which is the tube that carries urine onwards to the bladder. There are many treatments are available for PUJ after recurrence but unfortunately again Surgery is necessary. The obstruction needs to be removed so that urine can pass freely from the kidney down to the bladder. This can be accomplished by several means: Cutting out the PUJ obstruction and joining the kidney onto the ureter, pyeloplasty. Pyeloplasty i.e. cutting out the obstruction has the best results and lasts for the longest period. This can be achieved through a traditional surgery open pyeloplasty or by minimal access surgery, laparoscopic pyeloplasty. Making a cut in the PUJ obstruction so that it splits open and becomes wider that way endopyelotomy. A cut in the PUJ obstruction endopyelotomy is less effective than cutting it out altogether, but is possibly better than bursting it with a balloon. In some situations, it is dangerous because of neighbouring blood vessels. Bursting the obstruction with a balloon balloon dilatation. Bursting the obstruction with a balloon is quick, the least invasive but is less effective and lasts for the shortest period. Furthermore, it produces scarring that can make corrective surgery more difficult. For some patients it is the best option because poor health makes other treatment dangerous. In our opinion you should come to our world laparoscopy hospital to get Robotic Pyeloplasty done. For the experienced laparoscopist, application of the da Vinci robot resulted in significant clinical advantage and added substantial precision to transperitoneal laparoscopic dismembered pyeloplasty. Although procedure would be expensive but results are good. With regards Sadhana |
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re: hydronephrosis and renal pelvic obstruction (puj)
by Yogendra Chhetri -
Oct 14th, 2012
8:14 am
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Yogendra Chhetri
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I am from Kathmandu, Nepal. I got your email address while surfing the internet through Google. Now I would like to ask you some questions in relations to my 12 years daughter. |
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re: hydronephrosis and renal pelvic obstruction (puj)
by firdous ali khan -
Sep 8th, 2013
4:03 am
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firdous ali khan
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My child both side puj obstruction Dear Mr Khan Your child may need Laparoscopic Pyeloplasty Surgery. No medical therapy is available for the treatment of ureteropelvic junction (PUJ) obstruction. Conservative treatment is reasonable in situations in which the obstruction is asymptomatic and in due course of time if no evidence in deterioration of renal function exists, and the patient is free from recurrent infections or nephrolithiasis. Conservative treatment may be particularly appropriate in selected children with asymptomatic UPJ obstruction because the obstruction may regress as the child grows. Please consult a good urologist. With regard Sadhana |