The Causes of Kathrine's Kidney Pain

The Causes of Kathrine's Kidney Pain Dr. Travis: Joining us today is Katherine’s urologist, Dr. Jennifer Anger. She specializes in female urology and urologic reconstruction. She’s also assistant professor of urology at UCLA Medicine. So welcome to the show, Dr. Anger. Dr. Jennifer Anger: Thank you. Dr. Travis: One of the things that Katherine keeps describing is kidney pain and I won’t even look at it at a human kidney. It’s a very small organ. It lives just underneath your ribcage in the back and I’m going to show you the cross-section. Literally, blood comes into the kidney and then the kidney filters the blood and it flows through the ureter, to the bladder and so, one of the things that Katherine even worried about is that you have an issue with your kidneys. Katherine, you’re anxious to find out what would stop it, right? Katherine: I’m very anxious. I have been waiting all week to figure out what Dr. Anger found. Dr. Jennifer Anger: There was a tiny stone in the right kidney but, unfortunately, I don’t believe that’s the cause of her chronic pain. Dr. Travis: And we have a CAT-Scan of what that stone looks like for everyone at home. And it’s literally that little area circled in red, that little dot. That enhancement is a kidney stone but it’s not obstructing. It’s not a place where you would think it was causing her pain. Dr. Jennifer Anger: As you know, as an NER Physician, kidney stones cause pain once they leave the kidney and start tracking down the ureter. So, this stone is really tiny and it’s not causing any blockage. Dr. Lisa: And so, she also had a CAT scan of her ovaries to see if there was any cist. As you can see, there’s highlighted on the CAT scan there that she has a very small cyst, like 1 centimeter. And these can be in any ovulating woman. You can find the cist anytime because that’s the definition of ovulation. You get a cyst which is a sack full of fluid every month which the egg bursts out off. A lot of women can experience some pain with that but it’s cyclical. It comes at a regular time and if you keep a calendar, you can tell that. And we did a pelvic exam as well to determine there weren’t any gynecologic factor. Right Dr. Travis: So, you found the kidney stone. You found the ovarian cyst but what does this all mean because your theory is that that probably isn’t causing the pain? The kidney stone probably isn’t causing the pain. So, where does that leave us with Katherine? Dr. Jennifer Anger: We should also add that, a few years back, Katherine had a diagnostic laparoscopy and they looked for other possible causes, endometriosis and actually removed her normal appendix which is totally reasonable for someone with chronic, right-lower quadrant pain. We are always going to be thinking, “Is it the appendix?” And now, we know it’s not the appendix. So, really at this point, I think we need to stop looking for a source of pain because I think there’s nothing bad going on and Katherine needs to be reassured that there’s no malignancy, no cancer. She did have events that could’ve caused, in the past, maybe passing another kidney stone. But what I think it’s safe to say is maybe she has some nerve hypersensivity in that area but I think, rather than continuing to do invasive testing, I think we need to start transitioning and really treat her pain.