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?
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.