Ureteral Reconstruction and Kidney Function Assessment

Ureter and renal function

Hello, Dr.
Hsu.
I previously consulted you about the issue of "ureteral reimplantation," and I saw your response.
Thank you!
After being discharged, my follow-up appointment included an ultrasound, which revealed hydronephrosis in the left kidney (after the left ureter surgery).
The doctor has scheduled me for a "nuclear medicine imaging study," and I will return for the report in two weeks.
The doctor mentioned that urine is being excreted without any obstruction.
I noticed the curve graph showed numbers of 42.7 and 57; what do these numbers represent? (I forgot to ask the doctor.) Can this examination and data simultaneously assess the function of the ureter and kidney?

Han, 40~49 year old female. Ask Date: 2015/07/04

Dr. Xu Weikai reply Urology

Hello, I'm not sure either.
It might be the ratio of urine excretion from the two kidneys: one side at 42.7% and the other at 57.3% (just a guess).
To determine if there is any swelling in the ureters, an ultrasound or an intravenous pyelogram (IVP) can be used.
If there are any unclear points, feel free to ask again, and we can discuss and research further.
Answers found online should only be used as a reference; if necessary, it is important to seek medical attention at a healthcare facility.
The Ministry of Health and Welfare Taitung Hospital cares about you.

Reply Date: 2015/07/04

More Info

Understanding ureteral reconstruction and kidney function assessment is crucial for patients who have undergone such procedures, especially when complications such as hydronephrosis (swelling of the kidney due to urine buildup) arise. In your case, the ultrasound revealing hydronephrosis in the left kidney after ureteral reconstruction indicates that there may still be some issues with urine drainage, even if the doctor has stated that there is no obstruction.

The numbers you mentioned, 42.7 and 57, likely refer to the percentage of urine output from each kidney, indicating how well each kidney is functioning post-surgery. In this context, the left kidney is producing 42.7% of the total urine output, while the right kidney is producing 57.3%. This distribution can provide insight into how each kidney is compensating for the other, especially if one kidney is underperforming or has been surgically altered.

When assessing kidney function, several parameters are typically evaluated, including serum creatinine levels, blood urea nitrogen (BUN), and glomerular filtration rate (GFR). In your situation, the nuclear medicine scan is a valuable tool as it can assess renal perfusion and function, providing a clearer picture of how well each kidney is working. This type of imaging can help determine if there is any residual obstruction or if the kidneys are functioning adequately despite the surgical changes.

In terms of ureteral reconstruction, the goal is to restore normal urine flow from the kidney to the bladder. If there are still signs of hydronephrosis, it may indicate that the reconstruction did not fully resolve the issue or that there are other factors at play, such as scarring or kinking of the ureter. Continuous monitoring through imaging and laboratory tests is essential to ensure that kidney function remains stable and to catch any potential complications early.

If you are experiencing persistent issues or if the hydronephrosis does not resolve, further intervention may be necessary. This could include additional imaging studies, endoscopic evaluations, or even surgical revisions if indicated. It is crucial to maintain open communication with your healthcare provider and to discuss any concerns you have regarding your kidney function and the outcomes of your surgery.

In summary, the assessment of kidney function post-ureteral reconstruction involves a combination of imaging studies and laboratory tests. The percentages you observed in the urine output can provide insights into how each kidney is functioning and compensating for the other. Regular follow-ups and discussions with your healthcare team are vital to ensure optimal kidney health and to address any complications that may arise.

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