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Urology (Expert Forum)
right flank pain
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
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right flank pain
by Kathy, Nov 20, 1999 12:00AM
My 12 yr old daughter is having severe right flank pain..... She is taking 2 tylox and at times is given morphine in the ER or as an inpatient. she has a solitary kidney (rt side.. congenital)
the Dr's have said that she has a slight hydroneurosis of the kidney .. and have noticed a dillitation of her ureter midway to the pelvic brim.... but her flow is great... kidney function is normal all blood tests are within normal ranges... yet she is in severe pain.....
the doctors have said they see no reason for the pain. which began in May.... she has also has to bouts ofUrinary Incontience
Any ideas on what this could be..... My daughter cannot live on pain meds forever.... Please help.....
the Dr's have said that she has a slight hydroneurosis of the kidney .. and have noticed a dillitation of her ureter midway to the pelvic brim.... but her flow is great... kidney function is normal all blood tests are within normal ranges... yet she is in severe pain.....
the doctors have said they see no reason for the pain. which began in May.... she has also has to bouts ofUrinary Incontience
Any ideas on what this could be..... My daughter cannot live on pain meds forever.... Please help.....
Doctor's Answer
by hfhs M.D.-AK, Nov 22, 1999 12:00AM
Dear Kathy,
I don’t know what the term “flow is great means” I would need numbers, but I hope you are talking about the results of a renal scan with lasix washout. This is the standard test to look for obstruction (DTPA Renal Scan). A more complicated, test known as Whitaker test is used only in selective cases when the radiotracer cannot be concentrated sufficiently to allow for an adequate lasix washout. This is a pressure flow study that can sometimes detect obstruction in patients with equivocal Renal scans. The other possible diagnosis that would be less common is a Dietl’s crisis. This occurs when a functional obstruction exists. If a lot of fluid is being secreted in a short period of time (diuresis) the drain ( outflow) can function like a partially clogged system. If the kidney cannot drain fast enough, pressure builds in the renal pelvis causing pain, and this is not relieved until the fluid is eventually excreted. This causes intermittent pain, sometimes even nausea and vomiting.
Her incontinence would need to be worked-up by a specialist who deals with children and urology problems all the time. A pediatric urologist can handle these complicated cases well. If your daughter already sees a peds urologist, she is probably being worked up properly. An ultrasound, CT scan, CMG/EMG and even cystoscopy may be indicated. There are many types of incontinence and without a proper history, I don’t want to guess.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword: Pediatric renal colic
I don’t know what the term “flow is great means” I would need numbers, but I hope you are talking about the results of a renal scan with lasix washout. This is the standard test to look for obstruction (DTPA Renal Scan). A more complicated, test known as Whitaker test is used only in selective cases when the radiotracer cannot be concentrated sufficiently to allow for an adequate lasix washout. This is a pressure flow study that can sometimes detect obstruction in patients with equivocal Renal scans. The other possible diagnosis that would be less common is a Dietl’s crisis. This occurs when a functional obstruction exists. If a lot of fluid is being secreted in a short period of time (diuresis) the drain ( outflow) can function like a partially clogged system. If the kidney cannot drain fast enough, pressure builds in the renal pelvis causing pain, and this is not relieved until the fluid is eventually excreted. This causes intermittent pain, sometimes even nausea and vomiting.
Her incontinence would need to be worked-up by a specialist who deals with children and urology problems all the time. A pediatric urologist can handle these complicated cases well. If your daughter already sees a peds urologist, she is probably being worked up properly. An ultrasound, CT scan, CMG/EMG and even cystoscopy may be indicated. There are many types of incontinence and without a proper history, I don’t want to guess.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword: Pediatric renal colic
Member Comments (5)
by Larry A., Nov 22, 1999 12:00AM
To: Pediatric Urology
0
by Kathy, Nov 22, 1999 12:00AM
To: Pediatric Urology
0
by Ramona, Apr 03, 2000 12:00AM
To: Pediatric Urology
0
by andrea, Apr 16, 2000 12:00AM
To: Pediatric Urology
0
by Lesesha, Jul 11, 2000 12:00AM
To: Pediatric Urology
0
