The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
My wife is in the hospital right now. This is the second time we have been here. The first time was two weeks ago. She had a major stone blocking her kidney and a kidney infection. She has a nephroureterectomy catheter installed, and the bag is no longer filling up, and she had a fever last night, so we came to the hospital. She finished fourteen days of tablet Cipro and is on tablet Vancomycin now. About the infectious disease, the doctor said he is fine having the ureteroscopy done since she finished her antibiotics, and her infection is minor and not worse than it was two weeks ago based on the CT scan reports. She had a urinalysis done which came back negative for the disease. The problem we are having is that the urologist in the hospital will not do the procedure to remove the stone. Following up with her primary urologist will take a week and then more weeks before she can get the procedure done. She needs it done now because we risk another or more severe infection. The longer the stone stays and the tube stays in her back or kidney. We are not stuck in a loop because we will keep visiting the hospital trying to time this infection for the procedure. The urologist will not do the procedure to remove the stone without the infection gone, and the infection will not go away without the stone gone. We feel stuck and need help. Please advise us on this. We are just sitting here waiting for the culture to come back.
Thank you.
Hi,
Welcome to icliniq.com.
First, I want you to relax since the emergency treatment to unblock the kidney was done by nephrostomy or nephroureterectomy. Secondly, endoscopic treatment for the stone should never be done with active infection. The stone will be there, and antibiotics treatment should be continued till urine culture shows no growth, and the procedure should be done under antibiotics coverage. The main thing is not the stone, and now the main thing is to make sure that there is no blockage while she is on antibiotics, and the antibiotics are sensitive as per the last culture result. In case of fever, she needs admission and catheterization with hydration and blood urine culture with a broad-spectrum antibiotic until culture results are out. Once there is a window of no growth, then the operation will be done. It is too dangerous to operate during an active infection, which can lead to septicemia and intense care unit (ICU) admission. Hence not advisable.
Please do not rush things as long as there is no blockage.
Kind regards.
Patient's Query
Hi doctor,
Thanks for the explanation,
Hi,
Welcome back to icliniq.com.
You are welcome and take care.
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