USA TODAY US Edition

Doctor provides insights on kidney ailment

- Kim Painter

First lady Melania Trump’s office released few details about the medical procedure she underwent Monday or the “benign kidney condition” that led her to seek treatment at a military hospital near Washington.

Medical experts made some educated guesses about what was going on as Trump, 48, recovered from a procedure called an embolizati­on at Walter Reed National Military Medical Center in Bethesda, Md.

Monday, her office said the procedure was successful and there were no complicati­ons, but the first lady would remain in the hospital the rest of the week.

President Trump tweeted Tuesday that “our great first lady is doing really well.” He thanked well-wishers.

USA TODAY spoke with Jamin Brahmbhatt, a urologic surgeon at Orlando Health in Florida, about what may be going on with Melania Trump.

Question: What kind of “benign kidney condition” might require an embolizati­on procedure?

Jamin Brahmbhatt: The most likely culprit is a non-cancerous growth called an angiomyoli­poma. It’s made up of fat, abnormal blood vessels and smooth muscle.

A second possibilit­y is a blood vessel abnormalit­y called an arterioven­ous malformati­on.

A less likely culprit is a cyst, since it typically would not be treated with embolizati­on.

Q: What is involved in an embolizati­on?

Brahmbhatt: That is a general term for a procedure that blocks blood flow to a problem area of the body. In the case of a kidney abnormalit­y, doctors would typically thread a thin tube through a blood vessel, often starting in the groin, and inject a substance to cut off blood flow to the benign tumor or malformati­on. The idea is to stop or prevent bleeding or other symptoms and to shrink the abnormalit­y or at least stop it from growing.

Q: How are such kidney abnormalit­ies found?

Brahmbhatt: Most are found during imaging tests — MRIs, CT scans or Xrays — done for other reasons.

But some people have symptoms, such as pain in the flank or blood in the urine, when a benign tumor becomes quite large, leading their doctors to order testing. Blood vessel abnormalit­ies in the kidneys also can cause high blood pressure.

Q: Is it unusual to stay in the hospital for several days?

Brahmbhatt: Cases differ. Most embolizati­on procedures do not require several days of hospitaliz­ation, and many people go home the same day.

But in some cases, patients do stay for a night or longer to be observed for problems that can develop such as nausea, vomiting and pain, especially if a fairly large mass was treated.

Follow-up imaging also may be done.

Q: Who is at risk for an angiomyoli­poma?

Brahmbhatt: Women are much more likely than men to get them, by a 4 to 1 (ratio). About 20% of patients have a family history of the condition.

 ?? WIN MCNAMEE/GETTY IMAGES ?? Melania Trump underwent a procedure on Monday for a “benign kidney condition.”
WIN MCNAMEE/GETTY IMAGES Melania Trump underwent a procedure on Monday for a “benign kidney condition.”

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