Concerns Regarding Ureter Perforation and Contrast Extravasation in Laser Lithotripsy
At this juncture, I feel overwhelmed and uncertain about the path forward. I've tried contacting my physician and his staff, but due to their high volume of work, I'm struggling to get the information I need—often I am met with incomplete responses. Despite several conversations with the nursing team, I don't feel my concerns are being acknowledged. I am a 52-year-old female weighing 140 pounds, and I am worried about potential injuries to my ureters and urinary tract stemming from a laser lithotripsy procedure, as well as issues related to the extravasation of materials into my abdomen. My initial procedure took place in May, performed by a doctor with over two decades of experience and a solid reputation—I certainly do not wish to blame him. Unfortunately, my ureter sustained a perforation, leading to the cancellation of the surgery and the placement of a stent. After keeping the stent for two weeks, a second attempt successfully removed two 10mm kidney stones. At that time, contrast dye was administered, and no signs of leaking from the ureter were detected. During the first procedure, a retrograde dye and X-ray revealed the perforation, with the contrast medium exiting the ureter. Approximately two days post-procedure, I began experiencing significant bloating, resulting in noticeable abdominal distension. When I reached out for assistance, the nurse suggested I consult my general practitioner, stating that the situation did not appear to be urinary-related. Upon inquiring about the ureter perforation, she was unable to find that information in the medical notes, although my doctor had previously informed me about it. Fast forward to now: I have been experiencing severe bloating after meals and discomfort on the side where my kidney is located. I suspect some of the contrast material may have leaked into my abdomen, but I'm unclear on the extent. There’s also visible inflammation in my hip area, which seems to be about 5% larger compared to the unaffected side. Could this contrast substance have potentially harmed my internal organs? Who should I consult to gain clarity on my situation and receive appropriate care? Despite holding onto hope for the past eight weeks, my condition is worsening, and I feel lost in knowing what steps to take next. I recently underwent an ultrasound that yielded normal results and am currently waiting for the outcomes of an abdominal X-ray.
Answers (1)
6/21/2025, 6:20:37 PM
OpenHealth AI
I'm sorry to hear about the overwhelming situation you're facing. It’s understandable to feel anxious about complications following your recent procedures, especially with your symptoms persisting. Let's clarify what might be happening and outline some steps you can take.
Main Points:
- Potential Effects of Contrast Media: While it's concerning to experience symptoms like severe bloating and discomfort, it's essential to know that most contrast agents used in procedures like yours are typically safe. However, extravasation (leaking) can happen and needs to be monitored.
- Importance of Symptom Monitoring: Given your symptoms and medical history with perforation, keeping a close watch on changes in your condition is crucial.
- Next Steps for Clarity and Care: You should explore consultations that can provide a clearer understanding and appropriate care.
Explanation:
Ureteral perforations during procedures can lead to complications such as urinary leaks or irritation in the abdominal cavity. Contrast material that leaks into the abdomen usually resolves without significant harm, but can sometimes cause irritation and bloating. Your symptoms of bloating and discomfort, especially after meals, could indicate an inflammatory response or other issues needing further investigation. The visible inflammation on your hip could be related but requires assessment to determine the cause.
Specific Next Steps:
- Keep a Detailed Symptom Diary: Note down your symptoms' severity, duration, and any triggers (like certain foods), which can help a healthcare provider understand your condition better.
- Follow Up with Your Urologist: If your current doctor is busy, try to request a more immediate appointment or ask if there’s another doctor in the practice who can discuss your concerns about the ureter perforation and bloating.
- Consider a Consultation with a Gastroenterologist: Since you are experiencing significant bloating and abdominal discomfort, a specialist in digestive issues could provide insight and help rule out gastrointestinal causes.
- Request All Medical Records: Ensure you have access to all notes, especially those regarding the perforation and any imaging results, which can clarify what’s been found and guide your next steps.
- Discuss Imaging Results: Once you receive your abdominal X-ray results, follow up to discuss them immediately. Ask specifically if they examined for signs of complications related to your recent procedures.
I empathize with your situation and the frustration of navigating through the health system for clarity. Keep advocating for yourself, and don't hesitate to reach out persistently until you get the information and care you need. You are taking the right steps by seeking knowledge and support; stay hopeful, and keep me updated on how things progress.
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