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Is it normal to be in pain afer lithiotropsy and URS and passing blood and clots? Taken tramadol, morphine and codeine.

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61 yr old male: Just had two stones removed with lithiotripsy and URS. Is it normal to be in excruciating pain even two days after surgery, passing lots of blood and clots? No stents in. One stone was in ureter (removed with URS) other in calyx removed with ESWL. Taken tramadol, morphine and codeine, Still in pain. What is going on? Help.
Posted Fri, 27 Apr 2012 in Urinary and Bladder Problems
Answered by Dr. Rajiv goel 1 hour later

Thanks for posting your query.

A lot of times, after ureteroscopic removal of calculus, there can be residual edema in the ureter. This impairs the free flow of urine and hence the resultant pain.

You also had in addition, ESWL done, and it is quite possible that you may be still passing small stone fragments.

As long as you are afebrile, you don't need to worry and the pain shall settle soon. I suggest you should take non opiod analgesics and antiinflammatory agents under the guidance of your urologist. Both the above mentioned agents shall reduce the edema and thus the pain.

I hope I have answered your query. Please accept my answer if you have no further questions.
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Follow-up: Is it normal to be in pain afer lithiotropsy and URS and passing blood and clots? Taken tramadol, morphine and codeine. 2 hours later
Why non opioid? NSAIDs do not help. The only thing that has helped is morphine. I did another ultrasound and X-ray which revealed stone particles from the eswl have all come down and clumped together in the ureter causing a bit of blockage and kidney swelling. Also unsure but maybe the swelling may also be due to the eswl?
Is it normal to be passing quite a bit of blood and clots?
Yes. No fever is present and antibiotics have been administered.
Answered by Dr. Rajiv goel 2 hours later

Thanks for writing back.

You have formed steinstrasse in the ureter from the ESWL fragments. You need to stay relaxed; start yourself on alpha blocker under the guidance of your urologist. Watch for fever and follow up with repeat ultrasound scans.

It is normal to be passing blood and clots and they shall stop soon.

Even if NSAIDs are not helping; still take them for their antiinflammatory effect.

Hope, this helps. Please acccept my answer in case you do not have follow up queries.

Wish you good health.

Above answer was peer-reviewed by
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