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Question
I am a 46yr old female with a single left kidney. Right kidney was removed due to fibrosis and zero function after three surgeries to correct ureter strictures partially caused by scar tissue(keloid) and partially by a kinking of the ureter due to a floating kidney. Symptoms of stricture returned 5 years later, with remaining left kidney also diagnosed as dropping more than 5 cm when upright. Urine output fell dramatically and kidney function dropped to 15 percent. A stent was inserted to return kidney function. Unfortunately stent causes severe inflamation and pain upon walking. Currently on 2 myprodols and 1000mg aspirin three hourly for last five months. I have been unable to find a surgeon confident that he can perform nephropexy without substantial risk to kidney and I don't want to lose my only kidney. What painkillers could I replace the current combination with that would be safer for the kidney long term? It seems as if I am looking at having a stent long term. Unfortunately paracetemol does not work for me leaving the nsaids and the opiates asonly option and some opiates such as pethidine also do not work for me.

Answer
Liesl, I do not think that taking pain medication or having an indwelling stent are good long term solutions for you.  The latter needs to be changed periodically and is a potential source of infection.  In addition, you find it uncomfortable enough to require pain medication.  Nephropexy is a very low risk procedure and really should not impact significantly on the function of your kidney.  With any type of surgery, however, no surgeon can guarantee long term results.  I suggest that you reconsider having your kidney "pexed".  This just involves mobilizing the kidney and then keeping it in place either with sutures or mesh.  There is minimal risk to your kidney function which probably is less than the risks of long term pain medication and infection.  To follow is an article relating a series of nephropexies done laparoscopically with excellent results.  Good luck.

http://www.ncbi.nlm.nih.gov/pubmed/11458045

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Arthur Goldstein, M.D.

Expertise

Problems or questions related to the field of urology; ie urinary stone disease, urinary cancers (kidney, bladder, prostate, testis, etc.), urinary infections, etc. I no longer answer questions related to erection problems or male sexual dysfunction.

Experience

I am retired from the active practice of urology. My 34 years was totally in the clinical field and involved the entire gamut of genitourinary problems, with special interest in endourology.

Organizations
American Medical Association, American Urological Association, American College of Surgeons

Education/Credentials
College degree - BS Medical degree - MD Master of Science - MS

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