Patient: Description of condition (onset, main symptoms, hospital visited, etc.): Over 30 years old, congenital malrotation of kidney, ureteral stenosis, kidney stones detected at the age of 8 due to hematuria, stone extraction and ureteroplasty, now left and right kidney ureteral stenosis and water stones Three tests have been done, dual source CT, renal kinetics and retrograde nephrostomy (cystoscopy entered smoothly). Now we have three tests, dual source CT, renal kinetics and retrograde cystoscopy (cystoscopy entered smoothly), and the examination status is as shown in the picture. 1.Does the surgery have a high chance of success? How do you think surgery is good surgical treatment may be my best plan, but now there are different doctors have different opinions on the timing and method of surgery, doctors who hold the view of no surgery in the near future based on the following reasons, first, due to poor rotation, stone extraction surgery many doctors feel that there is a certain risk, and the chance of not taking the stone is very high; second, the cause of stone water is the high value of ureteral entry, but at the age of 9 years old to do ureteral The result of plastic surgery is not ideal, and the chance of success of the second surgery is not high. 3, poor kidney rotation cannot be plasticized. 2.Will I miss the best time for treatment if I treat conservatively? My current GFR is 99.5, how much does my pathology affect my kidney function without treatment, and what is the worst case scenario if treated conservatively? What is the worst case scenario if treated conservatively? I have searched for doctors in many places, but no one dares to take over me as a patient with certainty, so I am looking forward to your advice on the direction of treatment after visiting me. Sincerely thank you! Sun Fa, Department of Urology, Affiliated Hospital of Guizhou Medical University
Sun Fa, Department of Urology, Affiliated Hospital of Guiyang Medical University.
Kidney stone is a frequent and common disease, and its incidence is more in the south than in the north.
After reading your profile, your total kidney function is good, the left kidney has rotational dysplasia, but the current kidney function is good, and since the right kidney has multiple stones, both kidneys should be given more attention.
The right kidney has a history of pyeloplasty and currently has stones and fluid, which should still be actively treated. The best surgical option is percutaneous nephrolithotomy, which causes little damage and fast recovery. In other words, it is repeatable, unlike traditional surgery, which is not possible to perform multiple operations on the same site.
I don’t know which city you are in. But every provincial capital city can start the procedure, but you must choose a more experienced surgeon to reduce the complications of the procedure, so as to better protect the kidney function and at the same time improve the stone removal rate.
The effect of stones on the kidneys is mainly due to the obstruction caused by the stones. I would say that even if the stones remain, as long as the stones causing the pelvis and calyces are taken care of, the kidney function can be effectively protected. So when you talk to your doctor, don’t put too much emphasis on whether the stones can be taken clean or not, this will reduce the pressure on the doctor, otherwise, many doctors will choose not to take the consultation under the current tension between doctors and patients.