Kidney Stent?

Last week I saw a new urologist who is closer to us so we don't have to make the 95+ mile trek for follow-ups.

He honed in on my last renal scan on July 2010 with results that showed 11% function in my right kidney and 89% on the left. My former surgeon ordered that scan and said he would "let sleeping dogs lie" and if I started having kidney infections or pain, we'd address it then. He only mentioned surgery to remove the kidney.

This new doctor wants another renal scan and if the blockage is still there and as bad, he's wanting to go in and put in a stent with a drain bag to my back. This would stay in place 6 weeks then be removed.

I'm not sure I want to have this done. I've had no infections, feel great, and frankly don't see the need for doing this.

My last blood draw on 6/9/11 showed a creatinine of 0.9 and a BUN of 19, with a Bun/Creatinine Ratio of 21.1. There were no red flags on the report so I'm really having a hard time understanding his wanting to do this kidney stent thing.

Any thoughts from the experts? I might add that our primary care physician is a 20-year bladder cancer survivor with one kidney.

~Barb~

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Hi Barb,
What does your primary care doctor say? Does he agree that you need this stent? Did the doctor who wants to put in the stent tell you the reason for it? What is your GFR number, It tells if the kidneys are filtering the toxins out of the blood right. These are things I would surely ask.

They are removing a small tumor from my remaining kidney on Wednesday, I found out just as I was leaving he plans on putting in a stent? I plan on asking what kind of stent. I was under the impression it would go from the kidney to the bladder as the tumor is partly blocking my urine flo and I have a low GFR.

Take care and God Blessyou and your husband.
Fran

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Barb,

The problem is that if the kidney does not drain properly its function can be greatly reduced as greater and greater damage occurs. The tube he wants to put in is called a percutaneous nephrostomy tube and I had one in for several months before my RC. It really was not bad at all and did the job it was supposed to. I attached the tube to a "belly bag" that you wear around your waist, instead of a leg bag during the day, and to a night drainage bag at night. From what I understand, this will drain the kidney more effectively than a stent in the ureter. Maybe a second opinion is called for.

Good luck!

Pat

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My GFR in June was 62.3 and the normal reading says ">60.0 - borderline low.

My PCP says "I'm living with a dead kidney that's not functioned in years so I don't see the problem."

I guess when the next renal scan is done we will see what that one says.

The blockage is where the tumor was attached to the ureter as it dumped into the bladder. My husband said they told him right after my surgery that they had to "go up higher" on that side because of the blockage - guess that means where they attached everything to the conduit.

I'm wondering if I need to see a kidney specialist also.

~Barb~

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I misread your first post. I thought you said July 2011. Guess I would question why he wants to put in the tube too. Wish my kidney functions were so normal...lol.

Pat

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Hi Barb,

Although your creatinine is fine, it is unfortunately not a very good indicator of declining renal function. One can lose about 50% of total renal function and maintain a normal creatinine. Your GFR seems to support that as we would like to have GFRs of 100 or greater. Whether of not a stent would reverse this may, however, be questionable as the damage due to the blocked ureter may have already been done and not be reversible and it probably does carry a risk of infection. I would want to address those issues with the new urologist and what he hopes to achieve with a stent before I made a decision. If there was some hope that the stent would increase renal function, it might be worth doing to maintain that reserve of the second kidney.

jj

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JJ - I was SO hoping you'd check in and comment on this thread. Between what you and Pat have said I've about decided NOT to consent to the procedure for the stent.

He sent me right from his office for a chest x-ray and CBC and said his nurse would make arrangements for the renal scan with the hospital. Well, it's been over a week and I've not heard anything about the scan. Now I'm thinking the blood work was fine, along with the x-ray. I will call, however just to make sure. The PET in June was also fine.

Thank you both for your input - goes right along with my thinking.

~Barb~

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Barbara,
I don't have information as to what you should do but sending you my best wishes and hope that you don't have to endure any more medical problems.
Hugs,
Nancy

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Hi Barb,
On my 5 year checkup after my RC and neobladder it was found that both my kidneys were dialated. This was found with an ultrasound. The problem was scar tissue was blocking both ureters. They put stents in both ureters and also a nephrostomy catheter in through the back and down into the right kidney. This actually went thru the kidney and into the right ureter to meet up with the stent. I had them in place for several months while having 2 surgeries to correct the problem.
My question would not be why does your new uro want to do it, but why didn't your former uro do this a year ago to try to save a kidney. Anything foreign that is put into the body could be a source of infection, but this can be dealt with. I know with many of us, myself included, if we waited until we did not feel well, we would not be around to reply to this thread.
If I were in your shoes and there was any chance at all that the stents would improve kidney function, I would do it.
I wish you all the best.
Keith

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Thanks for the replies. I failed to mention earlier that the new uro was only hoping to get my right kidney function to 20%. His exact words were "I'm hoping we can get you to 20% from the 11% you are now pumping." If he'd have guaranteed me 75% I would have already had it done and be sporting a stent. Wearing ANOTHER urine bag isn't something I'm looking forward to even tho it's temporary. I really need to think about this, because at 69 years of age, going through this procedure to gain 9% hardly seems worth it - or maybe I'm just a wuss - LOL......

It probably doesn't help that I feel so darn good right now and have had only one mild infection 3 months after surgery 2.8 years ago.

~Barb~

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I don't know that it's relevant but I had a ureteral stent put in and then learned after the fact that they need to be changed every three months (ideally). This sounds different...like they are putting it in and then it will come out but if they are talking about leaving a stent in I would ask how long it lasts etc. and how it would get changed etc. best to you, Marilyn

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Marilyn is correct. Stents typically need to be changed out every 3 months. But there are exceptions, I had one in for 5 months.
Keith

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Barb

When my left ureter was found to be clogged (scar tissue), they put in a neph tube and eventually a ureteral stent to try to let the kidney recover but it did not. My kidney function numbers were 6%/94% and the uro wanted to take it out. At my preop visit to my primary doc, he said that as far as he was concerned, if it was below 15-20 percent, it needed to come out so as not to minimize the risk of infection. Thus, I had it out in May of 2009. 2 hr laparascopic surgery and my uro joked that it was a minor surgery compared to the R/C

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