What effect does a restricted ureter have on long-term kidney function?

Question

In Aug last year I had acute renal pain, in ultrasounds my left kidney was shown to be enlarged & not emptying properly, X-Rays showed no stone but a CT scan revealed a 6mm stone 2/3 of the way up my ureter.

In November this was removed ureteroscopically with a holmium laser. However, I continued to have pain, & a further CT scan this January revealed that my kidney was still enlarged & not draining properly. So on the 8th of this month I had another ureteroscopy with a pylogram, & was found to have a severe narrowing caused by scar tissue, caused either by the stone, or by the procedure to remove the stone.
I am due to go back to have the ureter widened & to have a stent inserted for a month.

My question is this, given that my problems started in August last year - 7 months ago, how long does it take for a kidney to become damaged when the flow of urine is restricted? Is any damage reversible?

Many thanks for taking the time to read this & for any help you can give me.

Thanks 'greatbrickhill' for your lovely answer, I fully intend to ask my consultant this when I next see him (which will be when I'm having the stent put in), but in the meantime if anyone out there has experiences that can help me then I'm interested to hear from them.
Also what were people's experiences of living with a ureteral stent?

Sorry Matador 89, but I asked about kidney function not what procedures are appropriate. My Consultant has already decided what he is going to do to relieve the narrowing. Blinding me with science... 'It may be curative in patients with isolated epithelial strictures (no involvement of corpus spongiosum). Stents are designed to be incorporated into the wall of the urethra and provide a patent lumen. They are most successful in short-length strictures in the bulbous urethra.'

That would mean something to a Urilogy Consultant, but it sure as heck don't mean anything to me as someone who simply has GCSE's in Human Biology and Human Physiology & Health.

Answer 1

Hi,

You poor thing I totally understand, I went through the urethra widening operation about 18 months ago. I'm please to say you will notice an immediate difference. In terms of long term damage, they will need to do a scan on your kidneys to see if there is any scarring on the actually kidneys themselves if not then you have escaped long term damage.

Make sure you are drinking loads of water at least 2.5 litres a day, it will help flush out the kidneys. Absolutely no tea or coffee.

Oh just to add on your further information I had a stent for a month also and its fine okay not the most pleasant thought I give you but as long as you follow the doctors advise its okay.

Best wishes though its horrible.

Answer 2

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Answer 3

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Answer 4

Dilation of the urethra may be attempted by inserting a sound (a thin instrument used to stretch the urethra) under local anesthesia. If urethral dilation is not possible, surgery may be necessary to correct the condition. Surgical options vary depending on the location and the length of the stricture. Cystoscopic visual urethrotomy may be all that is needed for small stricure. A urethral stent for cystoscopic insertion may also be used. The goal is to stretch the scar without producing additional scarring. It may be curative in patients with isolated epithelial strictures (no involvement of corpus spongiosum). Stents are designed to be incorporated into the wall of the urethra and provide a patent lumen. They are most successful in short-length strictures in the bulbous urethra. Complications occur when a stent is placed distal to the bulbous urethra, causing the patient pain while sitting or during intercourse. Other complications involve migration of the stent.
I add a link which carries information that you may find interesting.

http://pennhealth.com/
ency/article/001271.htm

Hope this helps
Matador 89

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Answer 6

I've had a stent in place for 2 weeks after my last ureteroscopy to remove amassive kidney stone. I hate to say it but it wasn't very pleasant. It was really quite uncomfortable but it may be that you can take pain killers for it. I'd stock up them if i were you.

I hate leaving such a pessimistic answer... it's not normally me but the best thing about a stent is when they take it out!!

I've had 3 PCNLs (keyhole surgery) & 2 ureteroscopies so I'm sending you lots of positive vibes to get you through your month.

Answer 7

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Answer 8

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However, whatever replies you get on this website please be wary. They will only provide you with more grief. Unfold your thoughts/fears to your Consultant. No-one else is going to cure you. Tell him/her your concerns/fears/worries/pain. You are a human being and they will understand you but you must tell them.
Go back to your Doctor and press the point. I would so dearly love to know for sure that you are going to gradually improve and that the whole mess will right itself.

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