Kidney & Ureteral Stones
Symptoms
- Back/ abdominal pain- especially when drinking fluids or alcohol.
- Urinary tract infection with fever
- Bloody urine (Hematuria)
- Abdominal mass (usually only in children)
Diagnosis
Combining all the following information helps to make a diagnosis of UPJ obstruction.
- A Complete History and Physical Exam:
- Blood work and Urinalysis: This lab testing helps assess the overall kidney function and whether overall kidney function is compromised. Frequently, if the kidney on the opposite side has normal function, the overall kidney function will be normal.
- Imaging Studies: X-ray studies such as an intravenous pyelogram (IVP), CT scan and/or diuretic renal scan may be performed. These tests are important because they give important information in making a decision about correction such as kidney function, degree of hydronephrosis, and anatomy of the blockage. In an IVP and/or CT scan, contrast is given in a vein, and then X-rays are taken to visualize where the urine drains from the kidney. The test will show a sluggish, dilated kidney with little drainage of the IVP dye from the kidney to the ureter.
When undergoing a diuretic renal scan, a small amount of radioactive substance is injected into a vein. Kidney function is assessed using scanned images of the kidney as it removes the substance from the blood. This test will show how much damage has already occurred, and the severity of the blockage. The time it takes for the radioactive substance to move from the kidney to the bladder is calculated. This is called the washout time. The washout time is normally under 10 minutes, but can be as long as hours in the blocked kidney.
