My 18 year old son was diagnosed with two problems simultaneously three months ago: Type 1 diabetes and UPJ [Ureteropelvic Junction] obstruction (blockage where the ureter joins the renal pelvis). It seems unlikely that two relatively rare events would occur at the same time. Is it possible that one event is related to the other? Could the obstruction have hastened the clinical onset of diabetes? Could the diabetes have precipitated the blockage?
We are working with an excellent endocrinologist and urologist. Understandably, neither individual cares to speculate by stepping outside the boundaries of his own expertise. Could someone with a good grasp of the overall picture comment.
The UPJ obstruction is now being managed successfully with a stent as a short-term solution. We are contemplating surgical repair of the ureter. Would it be reasonable to postpone (and maybe avoid) the surgery? Is it possible that satisfactory functioning would continue, or is it more likely that the UPJ obstruction would soon be raising havoc again?
So far as is known, there is no relationship between diabetes and ureteric obstruction. It is possible though that the stress of being investigated and of planning surgery may have provided a degree of anxiety that was sufficient to trigger a final decompensation of insulin production. Your son however, almost certainly has had the immunological disorder that ends up with clinical diabetes for many years.
It would be inappropriate for us to comment on further surgery. You should discuss plans with your son's urologist and if you ask I am sure that he would help you to get a second opinion.
Original posting 3 Dec 96
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