Kidney problems

Obstruction of the kidney

Obstruction of the kidney occurs if the tube draining the kidney (the ureter) becomes blocked. This may have many possible causes, which can be briefly rounded up in to 3 main groups: * obstruction from within the tube, such as a stone * obstruction from outside the tube, such as a tumour in a neighbouring organ * obstruction arising in the wall of the tube, such as a muscular thickening .

 In practice, the underlying cause may be of secondary importance, and the primary consideration may well be to unblock the system. It is remarkable how variable the symptoms may be. Some people will get excruciating pain, similar to that experienced by mothers during childbirth, whist in other people the obstruction may be completely silent, and the patient may well be completely unaware that anything is amiss. Likewise, the damage done may be very variable - in itself, a kidney can withstand short periods of complete obstruction with very little damage, but gradually the kidney can become severely damaged.

Many factors may determine the extent of the problem in any individual case. Thus, if you have an obstructed kidney, the urologist will be keen to know for how long it is likely to have been obstructed, and what is causing the obstruction - the presence or absence of infection will also be a crucial factor. X rays, ultrasound examinations, CT scans, renograms and endoscopy may all have a role to play in determining the nature of the problem.

Obviously it is impossible to go in to the treatment that will be recommended, as this will be decided by the outcome of the investigations.

Non-functioning kidney

Frequently, it is discovered that a kidney is non functioning, or at least functioning below maximum efficiency. If the damage has only been done to one kidney, then the other kidney is likely to take over, and it may be some time before the damage is discovered, but if both kidneys are affected, or if there is only one kidney present, then renal failure may well develop, and this is a situation that is usually handled by a non surgical kidney specialist, known as a nephrologist. If it is just one kidney that is damaged, perhaps by a long standing stone problem, then the surgeon's duty is to make sure that the remaining kidney is working well, and then deciding whether the "bad" kidney should be removed or not.

These days, removal of a small shrunken kidney can often be successfully carried out using a laparoscopic approach, which has a smaller impact on the patient, and a quicker recovery time, but your surgeon will be able to advise whether this would be appropriate in your own case.

Cancer of the kidney

Cancer of the kidney is a disease that will kill if left untreated. The only reliable treatment is removal of the kidney, although there are a number of exciting developments. There are many different ways in which the disease will present, but quite frequently the lump in the kidney will be found as an incidental finding during a scan that has been requested for an unassociated problem. Once found, a lump in the kidney will be "staged", usually be carrying out a test known as a CT scan. This will give the doctor looking after you an impression as to how far the disease has spread (if at all), which will help determine the best treatment for your condition.

Surgery (which increasingly may be carried out laparoscopically) is likely to be recommended, but some of these tumours are very slow growing, and simple monitoring of the problem may well be recommended in some cases.

Cancer of the ureter

This not a very common problem, and is usually discovered as a result of investigation after passing blood in the urine. Full staging will be carried out, so that the extent of the problem can be established, and the usual treatment will involve removing the whole of the ureter, together with the kidney above it, usually through a combination of laparoscopic and open surgery. The main problem with the condition is that subsequent checks of the bladder and other ureter will be needed, to catch any further tumours that may occur at a very early stage.

Cancer of the testis is a condition that usually affects younger men; indeed, it only rarely occurs in men over 40. There are various types of testis cancer, and the initial treatment will almost certainly involve removing the whole testis, to establish the type of tumour that has occurred. This is relatively minor surgery, and whilst some men will have trouble coming to terms with the loss of a testis, most men do not get a body image problem of any severity - for those who do, an artificial testis can be inserted, and these are usually extremely convincing. Further scans may then be carried out, and referral will be made to a specialist centre, where further treatment can be organised if necessary.

Almost all testis cancers are curable given the correct treatment, and whilst this may be a fairly daunting prospect, most men will make a full recovery. A visit to www.BobChampion.com may be well worthwhile for anyone who has just been diagnosed with this condition. 

Urinary stones

Stones in the urinary tract are a fairly common problem, and may occur anywhere from the kidney to the tip of the urethra. Removing bladder stones used to be the prerogative of the old barber surgeons, but fortunately, Sweeney Todd has had his day, and sophisticated treatments are now available which are both effective and painless.

To cover the whole topic in a few lines is impossible, but suffice it to say that most stones will pass spontaneously, and cause little damage, but the pain they can cause may be intense, so don't hesitate to seek help. The ones that don't cause pain are perhaps more serious, as they can develop insidiously, so if you pass blood, keep getting urinary infections, or keep getting a sensation of a full bladder, and can only pass small drops at a time, then seek advice as, if it is a stone, help is readily available. If a stone is found, then treatment will be offered that is appropriate to your own particular circumstances.