Renal Edema: Navigating Urological and Gynecological Challenges - Urology

Uncertain cause of renal edema and subsequent developments?

---

I'm sorry, the article is quite long.
Actually, I underwent laparoscopic surgery in early June, but only had a double J stent placed and did not have the fibroid removed, so the problem remains unresolved, and I'm still contemplating the next steps.
My menstrual cycle has always been regular, and I rarely experience menstrual pain, so I initially didn't think to visit a gynecologist.
Due to a busy work schedule, I went to an internal medicine clinic for a check-up in April, where several urine test results were close to elevated levels, indicating that if it worsened, I could experience hematuria.
However, since the clinic wasn't specialized, they just advised me to drink more water and cranberry juice.
In mid to late May, I visited the urology department at Shuanghe Hospital for further examination.
The results included: an ultrasound showing right kidney enlargement, X-rays showing no stones, an IVP indicating obstruction in the urinary system up to the right ureter, and a CT scan revealing a foreign object in the uterus.
The urologist suggested it was a hydrosalpinx compressing the ureter, so I was referred to obstetrics and gynecology.
During the internal examination, the gynecologist found the foreign object, but while performing the ultrasound, he kept mentioning something strange to the technician, which I couldn't understand.
During a discussion between the gynecologist and the urologist, I overheard them mention a sausage-like object, approximately four centimeters long, but they were uncertain whether to proceed with an open surgery or laparoscopic surgery.
However, I was scheduled for hospitalization and surgery two days later.
They also mentioned that the urologist would come to place a double J stent to protect the ureter.
During the surgery and recovery period, the doctors explained to my sister and me that the situation was as follows: there were too many arteries around the fibroid, so they decided not to remove it via open surgery for now, and the four-centimeter object could not be removed laparoscopically either.
They temporarily placed a double J stent to straighten the apparently obstructed right ureter, and we would reassess the situation in three months.
Of course, it would be a lie to say I wasn't disappointed, as this essentially meant the problem was unresolved.
My sister was very upset, and family members who came to visit said I should definitely switch hospitals afterward.
My hospitalization was quite difficult.
Normally, I should have recovered quickly from a minor surgery, but I ended up staying for six days.
Initially, there were issues with the urinary catheter.
The nurse insisted that it could only be removed the evening after the surgery, and when the gynecologist came to see me, he was surprised to hear that it hadn't been removed yet and instructed the nurse to take it out immediately.
However, after it was removed, I faced even more difficulties; I felt an overwhelming urge to urinate but couldn't.
The nurse suggested Kegel exercises and other techniques to hold it in, but I endured until I turned pale and was trembling, still unable to relieve myself, which caused me to cry out in pain.
Eventually, the gynecologist had to come back and decided to reinsert the catheter.
His explanation was that the prolonged surgery had overstretched my bladder, so I would need to practice urination afterward.
The next day, the urologist came by and mentioned that the double J stents on both sides were causing some issues that prevented me from urinating.
In short, the two doctors had differing opinions.
During the urination practice, their recommendations also conflicted.
The gynecologist believed I should wait for my bladder to return to normal, while the urologist leaned towards removing the double J stent from the normal left ureter.
Ultimately, since the gynecologist was the primary physician, we followed his approach.
After being discharged, I had follow-up appointments with both departments.
The gynecologist checked the surgical wound and scheduled a follow-up in a month to assess the size of the fibroid.
The urologist performed an ultrasound and confirmed that the kidney was no longer enlarged and had returned to normal.
After that, I was to have regular follow-ups.
Now, a little over a month later, I am experiencing pain in my left flank.
Last Tuesday, I returned to the gynecology department and mentioned my left flank pain, leading to a urine test that indicated elevated hemoglobin levels and inflammation, for which I was prescribed anti-inflammatory medication.
I asked, "Should we check if the fibroid has grown?" The doctor replied that it wasn't necessary, as there wouldn't be significant changes in just a month.
I thought to myself, "Wasn't the follow-up scheduled to assess changes?" Last Friday, I went back to the urology department, where the doctor performed an ultrasound and stated that both kidneys were normal.
I mentioned, "Previously, it was said that urination would cause pulling sensations, leading to flank pain on both sides." The doctor explained, "However, recently, I haven't felt pain on the right side during urination; instead, the left side hurts all the time, especially during urination." He clarified that since the double J stent is a foreign object, discomfort is to be expected.
I am scheduled to have the left double J stent removed this Friday.
-- This summarizes my situation.
I've generally been in good health throughout my life, so I'm unsure if this treatment process is normal, but I have several questions: 1.
Why was the surgery initially planned to remove the uterine fibroid but ultimately did not? It seems the gynecologist implied that my urination issues weren't related to that, while the urologist believes they are.
2.
Who should I primarily consult regarding my issues? The differing opinions from both departments are quite confusing.
3.
Why was the left double J stent placed after the decision was made not to remove the uterine fibroid? It's normal to feel discomfort from a foreign object in a healthy area, so why proceed with the placement? I've been experiencing persistent pain in my left flank, making me want to yell at the doctors.
4.
The double J stent can only remain for three months; what happens afterward? How should I seek further consultation? 5.
Currently, I have significant pain in my left flank during urination, and my urine appears slightly red or tea-colored; could this indicate an infection? I would appreciate your professional answers, as I'm unsure whom to ask.
Thank you.

---

Ellie, 30~39 year old female. Ask Date: 2010/07/26