Atrophic kidney

In July 2006 I had a radical cystectomy (due to Bladder Cancer). My last CT Oct.4.09: bilaterial hydronephrosis and ureteral dilatation more pronounced on the left at this time and slightly more pronounced bilaterally than seen in 2007. Appearance is otherwise chronic. No finding of urinary calculi. The right kidney is relatively atrophic compared to left, a chronic pattern seen on prior exams. No gross focal renal mass is seen. There is no perinephric or periureteral fluid or edema. No pertoneal fluid is encountered.

My Urologist has indicated that this is not unusual due to what I've gone through. I want to know more about what is going on and what if any can I do to prolong my life if it is to be. I'm a strong Christian and I understand it's okay cause I am in God's hands. But in the mean time, I have an appointment with a Nephrologist on Jan. 15th. At this point I would like to understand what is going on and what to expect and what my options are if any.

My question to you. Can you give me as many pertinent questions as possible to address with my Dr.? I enjoy doing my research and sometimes difficult finding the right site to communicate. I appreciate any help you can give. Thank You so much and God Bless You for your work in helping so many.

Mary Doane

[DoriSchatell]

Hi Mary,

Wow, you've really been through the mill! I'm impressed with your knowledge about your condition. i wish everyone knew as much about their chronic health problems as you do. Do you know if you had hydronephrosis before your cancer surgery? Did the surgeon make you a new bladder?

I was curious about why hydronephrosis would occur in bladder cancer. Unfortunately, it appears that the reason may be cancer invading the muscle cells. Outcomes look to be better in people who don't have this complication. That said, statistics apply to groups, NOT individuals--and your surgery was already 3 and half years ago. Your faith and knowledge have helped you so far! :-)

One article I found did suggest active management of hydronephrosis by putting stents into the ureters, if needed, to open them up. Here is a link to the full-length pdf of this article: http://www.springerlink.com/content/...6/fulltext.pdf. I guess if it were me, I would want to know:
-- If the doctor plans to treat the hydronephrosis, and if not, why not.
-- What evidence does s/he think there is for making a decision?
-- What would the downsides of treating the hydronephrosis be?
-- Are there options for treating it other than stenting?

Good luck, and let us know how it goes.