human
Pregnant with kidney mass38 yo female 24 weeks pregnant (IVF) History of hydronephrosis (2017) 3.5 cm simple kidney cyst found while hospitalized for it as well as ovarian cystsI am currently 24 weeks pregnant, I had some pretty bad pain in the same kidney that I had hydronephrosis in years before. The pain only lasted for about an hour but I then had what felt like a UTI so I went to the doctor. My urine tests came back fine but my doc requested ultrasound of my kidneys given my history. I went and got it done and received a call the following morning to go straight to ER that I had an abscess so I did (4.7cm). My urine and cbc both came back ok and didnt indicate any infection so they sent me home with order for another kidney ultrasound in two days. I got that done and it came back complex mass 5.7cm with recommendation for MRI that I cannot get done while pregnant. I have been told that its ok to wait these 4 months but I cant help but be terrified in the meantime. I have an appointment with urologist in 2 weeks. What am I really looking at here? On a scale of 1-10 how concerned should I be that this is cancer? Google is really scaring me. I plan to have MRI while in the hospital after I deliver. What can I anticipate at the urology appt? Any insight is greatly appreciated. Thank you for reading.
gpt
Youll have to wait for the imaging study, but the wait shouldnt be a big deal. I prefer CT renal protocol over MRI, but maybe your urologist may feel differently. Based on the report its hard to say exactly whats going on. Theres no mention whether it is solid or not, which is critically important. Maybe just be a benign complex renal cyst. CT or MRI will clarify.Pelviectasis is minimal dilation of the renal pelvis. Based on your symptoms it sounds like you probably have a mild UPJ obstruction causing intermittent pain (Deidls crisis).Edit: spelling
Bleeding vs. clotting risk - When is heparin bridging appropriate?Hi all, I am just a simple-minded EMT, trying to understand this concept for a family member who recently underwent surgery.The family member has chronic a-fib, which has been well managed with warfarin. He needed a trans-urethral resection of a bladder tumor (TURBT). His cardiologist said he should not be off warfarin for more than 72 hours, and his urology surgeon said to stop the warfarin 48 hours in advance of the surgery (meaning the plan was to resume the warfarin 24 hours after surgery). After the surgery, the surgeon said he was not able to cauterize all of the 'wound' (I am not sure the correct term here), so my family member had a good amount of hematuria, though the surgeon said it was not a life-threatening amount.He was supposed to take aspirin after being discharged, but they ended up admitting him due to a good amount of clotting in the bladder, which required daily irrigation. I am not sure if the nurses ever ended up giving him aspirin or heparin while he was off the warfarin. The surgeon seemed very concerned about the bleeding, and said that my family member could not go back on his blood thinners for another 48 hours after the initially planned resumption (which would result in a total of 5 days off the blood thinners).Now my question is, isn't it easier to fix a bit of bleeding than a blood clot (which could cause CVA, AMI, or PE)? Wouldn't it be better to keep him on blood thinners and handle the bleeding, than to risk a deadly clot?We would ask his surgeon, but it's sort of a foregone conclusion at this point as my family member has already been discharged. So, this is just for my personal education. Thanks for your insight.
isn't it easier to fix a bit of bleedingGeneral surgeon here. No, it's not always easier. Sometimes the tissues are just oozy, and you can't just throw a simple suture in or cauterize it and make it stop. Sometimes, the more you cauterize something thats oozy and inflamed, the more it oozes and bleeds on you. Sometimes, you just need to let the body do its thing and form a clot. So either you stop blood thinners for as small a window as possible, and accept the risk of developing a clot elsewhere, or you keep them on blood thinners and just let them ooze and ooze and ooze, potentially requiring blood transfusions, which then opens them up to other risks. Others may have other viewpoints, but this is from a surgical view.