### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
SIR/MADAM, I AM 41 YEARS OLD & DURING PREVENTIVE HEALTH CHECK UP IT IS FOUND THAT THERE IS A PUJ BLOCK TO MY LEFT KIDNEY. I HAD DONE SONOGRAPHY, BLOOD TEST & ALSO TESTED INJECTING WITH RADIOACTIVE SUBSTANCE. SUGAR & OTHER LEVELS ARE OK. BUT TESTS SUGGESTS THAN LEFT KIDNEY IS ALMOST WEAR OUT & IT FUNCTION 8% WHILE RIGHT ONE IS FUNCTIONING @ 92%. DOCTORS R SUGGESTING THAT THEY WILL PERFORM OPENSURGERY (PYLOPLASTY) & IF FOUND THAT KIDNEY IS DAMAGED COMPLETELY, THEY WILL REMOVE IT.THERE IS VEY SMALL PAIN RIGHT NOW. SOME DOCTORS, PARTICULARLY AYRUVEDIC ONE SAYS THAT IF THERE IS NO PAIN, & PUJ BLOCK IS FROM CHILDHOOD, RIGHT KIDNY HAD TAKEN COMPLETE LOAD, HENCE DO NOT OPERATE UNTILL THERE IS SEVERE PAIN. PLEASE SUGGEST WHAT TO DO?

### output:

His understand your concern. PUB obstruction can sometimes damage the kidney without producing symptoms as is the case with you. I hope you have had CT scan of your kidney and the genogram is a DMS scan and not EC or MAG3 or DTPA genogram as DMS scan is better at estimating function of kidney. If the function is below 15% on DMS genogram and there is very little cortex left in the kidney on CT scan then the only option is to remove the kidney. I would advise against not doing an operation as if infection happens then it can be life-threatening, and I have seen patients becoming very sick with in a matter of minutes. I will also not advice pyeloplasty in such a scenario(unless there is good cortex in the kidney) as it will almost always fail, and you might need to have the kidney removed in the future in another operation.