I had a quick call from the urologist’s medical secretary just before Christmas. Apparently he has changed his mind about the test, and now wants to run a MAG3 Renogram. On the surface there appears to be no great difference to the IVU test, but it seems that there are advantages in terms of the amount of fine detail that can be determined.
In common with the IVU test, the urologist can determine problems with blood flow through each kidney, as well as problems with the drainage from each kidney to the bladder, showing the location of any blockage or restriction. However, in addition it is possible to measure the relative and absolute efficiency of each kidney, which can be useful in determining whether or not kidney function is impacted to the point where intervention is required or not.
If I get to the point where it is required, the question will be what level of intervention I can cope with. Options involving stents are only temporary, and require a general anaesthetic each 6 months to renew them. Not good. Options with balloons to “stretch” the tissues around a restriction to open up the ureter tend to be limited in effectiveness. I’m told that the gold standard is normally to “replumb” the ureter, but that’s going to be a massively difficult undertaking in my pelvis thanks to all my previous surgery. Not ideal.
But if the kidney function is sufficiently degraded for long enough then the kidney will eventually shut down. At that point it’s normal to remove the kidney. Apparently you can get by on less than half a kidney, so losing one isn’t the end of the world. But again, removing one of my kidneys is going to be a lot harder than normal.
So right now I’m hoping for a test result that shows my kidney function is good enough to not require any action at all.