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Have stone at vesicoureteral junction. Had septic shock. Placed Nephrostomy tube. Chances of stone passing out or surgery?

DOCTOR OF THE MONTH - Apr 2013
Apr 2013
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General Surgeon
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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?
Posted Sat, 22 Jun 2013 in General Health
 
 
Answered by Dr. Ivan R. Rommstein 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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