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Urology and the kidneys

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Every day, I get asked if I “deal with kidneys” or if “I see women also”. This is over 10 years after coming back to this country. It means that some people do not understand what I do as a urologist, even after describing what I do many times. The answer to both questions is yes, I do deal with the kidneys and I do see women patients. I also see women and children as they both have kidneys, ureters and urinary bladders and urethra.{{more}}

The kidneys are two bean-shaped, but fist sized organs lying in the back of the belly, up under the lower ribs. The kidneys produce urine that travels to the bladder where it is stored before it is passed out in the open when it’s convenient and private (even though some Vincentian men don’t need privacy). The tube that carries the urine from the kidney to the bladder is called the ureter and the tube that carries the urine from the bladder to the outside is called the urethra. The words are similar but different. The ureter can be called the inside urine passage and the urethra the outside urine tube. Because the urethra runs in the male penis and near the prostate, we urologists also deal with the male internal and external sexual organs.

Urologists are firstly surgeons; we become associated with men’s health for opportunistic reasons, namely men are more afflicted with sexual problems as they get older. Men also place more emphasis on their sexual organs than most other parts of their body; so, we urologists exploit the opportunity to educate and inform men about the other parts of their bodies when they attend our offices to get their sexual bits checked out. That’s why most Vincentians associate me with prostate and men’s issue. However, only 30 per cent of my daily work is prostate related. In every 10 patients I see, six are men, three are women and one is a child.

I get asked questions like “Doc, how do I know my kidneys are failing?” and “how can I tell if one or both kidneys are failing?” Questions like these let me know that there is a need for information in our country. The answer is, generally you cannot tell that your kidney is failing, but you can tell when it has already failed, i.e. when it’s too late. Likewise, a disease like a kidney stone or cancer can affect one kidney and it “fails,” but unless the other kidney is bad you cannot tell when one kidney has failed because the other kidney usually has enough reserves to “take over” the function of the failed kidney.

So, how do you know you have a kidney problem? Usually, you don’t know, but you can have an idea from what you feel or see. The usual symptoms are pain, blood in the urine, swelling of the feet and rest of the body, itching and darkening of the skin, weight loss, upset stomach, and vomiting and frothy urine.

PAIN: kidney pain is located in the area of the kidney called the loin. That is the area in the back, not front, of the belly, between the small of the back and the lower ribs. Not in the small of the back, but just above it at the bottom of the rib cage. The pain is usually dull and persistent, boring in nature and not relieved by a change in position or movement. The most common causes of kidney pain are infections, blockages from stones or kidney tumours. The pain from infection and blockage from stones are usually sudden, sharp and intense, while that from cancer is usually dull and of less intensity, even when the cancer is big.
 
The pain from infection is usually associated with a fever, nausea and vomiting, whereas the stone pain is usually associated with vomiting only. If the stone is in the kidney and blocking the kidney or causing infection, then the above type of pain is what you will feel. However, if the stone is in the ureter, then the pain can “wax and wane” in nature. This type if pain is called colicky pain, and it tends to shoot down towards the bottom of the belly on one side. This classic type of pain is called renal or ureteral colic and classically occurs, like above, in the loin, but shoots down to the groin, is sharp and intense and is associated with vomiting and sweating and sometimes blood in the urine.

Next week, I will look at the other symptoms of kidney disease.

For comments or question contact: 
Dr Rohan Deshong

Tel: (784) 456-2785

email: [email protected]

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