For the last few months, a 38-year old married woman was detected to have a poorly functioning left kidney when she went for a routine health check up. She was evaluated by doctors elsewhere and was advised removal of left kidney considering it to be a congenital problem (by birth). Another Urologist advised her to forget about the kidney as it is poorly functioning. Patient and her husband were in deep distress hearing this
The couple finally visited NU Hospitals, Padmanabhanagar - Bengaluru for an expert opinion. "Upon further enquiry and investigation, she was completely normal without any symptoms but her reports suggested she had only a seven percent function remaining in the left kidney. To our surprise, she had an ultrasound done six years back which reported a completely normal left kidney. This information was very crucial which made us investigate more and the problem was not by birth as mentioned by the other doctor. This is quite important as patients need to preserve older reports which can help doctors in analysing the current situation. On further imaging, it was found that the left ureter (pipe connecting kidney to bladder) was actually compressed by the large bulky uterus and this led to poor functioning of the left side kidney, because of the obstruction”, said Dr Vinod Kumar - Consultant Urologist at NU Hospitals.
Gynaecology consultation was taken and the patient was further found to have uterine adenomyosis (non-cancerous growth from uterus) which was causing her excessive bleeding and pain during menstruation. "She was planned for uterus removal by the gynecologist. After studying the kidney images and as the patient was young, it was decided to save the kidney by repairing the left ureter instead of removing it. Both the surgeries were planned at the same time by two teams consisting of Urologists and Gynecologists. Recently, the patient underwent successful removal of her uterus along with repair of the left ureter that was blocked. Guess what !! Both surgeries were done laparoscopically (keyhole surgery) without making any large cut in the abdomen. The large uterus with its growth was removed through vagina. Patient was stable, recovered well and was discharged.
After one month of follow-up she is very happy and at the same time thankful as her dual problems were taken care of simultaneously", added Dr Vinod
Doctors say that excellent team work between Urologist and Gynaecologist of NU Hospitals did the trick for the patient as a single surgery solved two issues for the patient.
For patients, it is necessary to provide a detailed history of the case and also to preserve the old reports. Many don't go for routine checkups. But, this case demonstrated how yearly health check-ups are essential and may pull a rabit out of the hat
Doctors always suggest that it is better to take a second opinion in complex cases and go for an expert in their respective fields.
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