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Have Stone At Vesicoureteral Junction. Had Septic Shock. Placed Nephrostomy Tube. Chances Of Stone Passing Out Or Surgery?

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Posted on Sun, 23 Jun 2013
Question: I HAD A 4MM STONE AT VESICOURETERAL JUNCTION WITH MILD HYDRONEPHROSIS BUT WENT INTO SEPTIC SHOCK WITH 3 DAYS IN MICU ON PRESSORS 3 wks ago. A NEPHROSTOMY TUBE WAS PLACED & is still in place. . iF THIS IS THE CASE, WHAT ARE THE CHANCES OF THE STONE PASSING ON ITS OWN IF NO FLUID GOES THROUGH THE URETER? I BECAME SEPTIC AGAIN AFTER COURSE OF ANTIBIOTIC. IS IT RECOMMENDED STONE BE REMOVED RIGHT AWAY (BEFORE NEXT INFECTION )since drs. won't remove nephr. tube until stone is out?
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Answered by Dr. Dr. Ivan Romich (36 minutes later)
Hi and welcome to XXXXXXX Thank you for your query.

since there was septic shock it looks like this was complete ureteral obstruction. Stone can be passed spontaneously even whithout urine flow because peristaltic waves are causing pressure on stone and moving forward, not urine.
of course that nephrostoma shouldn't be removed if stone is still verified at same place but I wonder why some of surgical or endoscopic procedures for calculi extraction weren't performed if there is no contraindicaton especially if 3 weeks passed and stone is still there. Consult your urologist about this.

wish you good health. If you have any question I ll be glad to help. Regards
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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Dr. Ivan Romich

General Surgeon

Practicing since :2008

Answered : 13889 Questions

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Have Stone At Vesicoureteral Junction. Had Septic Shock. Placed Nephrostomy Tube. Chances Of Stone Passing Out Or Surgery?

Hi and welcome to XXXXXXX Thank you for your query.

since there was septic shock it looks like this was complete ureteral obstruction. Stone can be passed spontaneously even whithout urine flow because peristaltic waves are causing pressure on stone and moving forward, not urine.
of course that nephrostoma shouldn't be removed if stone is still verified at same place but I wonder why some of surgical or endoscopic procedures for calculi extraction weren't performed if there is no contraindicaton especially if 3 weeks passed and stone is still there. Consult your urologist about this.

wish you good health. If you have any question I ll be glad to help. Regards