Suffering from pain in penis and kidney after laser lithotripsy for kidney stone problem. What could it be?
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38 year old male, 190 lbs, 6ft tall. Caucasian. History of kidney stones since XXXXXXX of 2013. 3 in right kidney, all about 3mm passed naturally. Very painful. Found 2 more in left kidney during CT scans. One in left kidney about 4mm got stuck in lower part of ureter and after 12 hours would not pass. CT scan showed it was obstructing. Went in for laser lithotripsy with Urologist with 25 years experience. Had surgery and all seemed fine. Dr said he got the 4mm stone, and went up into kidney and got the other small stone that was there to prevent it from coming down. Had a number 18 catheter placed, and had a stent placed in left ureter for 8 days and came back for outpatient removal. Surgery was on 9/12/13. All of this went according to plan. Dr said there would be some pain and discomfort associated with stent, and there was. Blood in urine for a few days. Went in for stent removal, which was fine, and Dr advised that there may be a blood clot that passes and that would feel like a kidney stone. Felt great for about 3 days after the stint removal, then began to experience pain again in left kidney and pain in end of penis, similar to what the pain of kidney stone felt like. This continued for about 3 weeks and I scheduled an appointment with Dr. Dr performed additional cytoscopy to make sure bladder, and ureter entrance looked ok. All was fine. Dr also had ultrasound performed to make sure urine flow was good. All appeared normal. Dr advised that all was ok and that I may have some leftover irritation from surgery. He gave me cipro, and Uribel and sent me on my way Oddly enough, the day after that visit in Mid October, the penile pain and kidney pain went away for about 3 weeks. Then about the first week of November, the kidney pain, penile pain, burning during urination, and general fatigue and malaise came back. This also occurred the same time I caught a sinus infection. So I scheduled another appointment with my Urologist. This time, he took another CT scan (had 5 in 6 months now) even though he said it was not good to have that many. This CT showed nothing in the right kidney, a very small (1-2mm) stone in left kidney, but no swelling, or issues in left kidney at all. He also said he could not find any stones in the left ureter, but there was some "vein calcifications" near the ureter that looked like a stone, but there was no signs of hydronephrosis. The Dr, then proceeded to performed Digital Rectal Exam in which he extracted some fluid from my prostate. He examined this, and stated the white blood cell count was high in this fluid, this leading him to conclude I had a prostate infection, which has similar symptoms. He prescribed sulindac for pain, and cipro 500 twice a day for 6 weeks. Now 10 days into the cipro, I am not seeing any symptom relief, and actually the night before last, I had to take a hydrocodone for the pain. (I have these from my previous kidney stone attack, and only use when I have severe pain.) Also I have noted that when I take a tamsulosin, that it feels like the pain moves, but I cannot be sure of that. Today the pain is okay, but it's constant, and consistent. On a scale of 1 to 10, it's a 2 or 3, but it is 24 hours a day. So, should this pain be here, this long after surgery? If I have a prostate infection, when will it begin to clear up? What other issues could cause these symptoms. Dr says he does not see any signs of stricture in the ureter, and I do not see any additional pain when I drink lots of fluids. If anything, it seems to be less painful if I drink more fluids. Any suggestions, and help is appreciated.
Posted Tue, 17 Dec 2013 in Urinary and Bladder Problems
Answered by Dr. G.Srinivasan 1 hour later
Brief Answer: Probably edema of the ureter------------------- Detailed Answer: Welcome to the forum. I went through your detailed history. The stone problem was handled appropriately, according to me. The present pain could be due to either edema of the ureter, causing intermittent blockage or due to prostate infection called prostatitis, due to high wbc count in the fluid expressed. I vote for the former considering history of recent procedure. Cipro should help manage prostatitis, if present. So i think you are in the correct course of treatment. It is hard to give a time frame but roughly it should take about 3 to 4 weeks for a response. Wish you speedy recovery, Truly,
Follow-up: Suffering from pain in penis and kidney after laser lithotripsy for kidney stone problem. What could it be? 8 hours later
So it can take up to 4 weeks to see symptom relief from prostatitis? could the surgery have caused this? How could the ureter have edema? stricture? should I ask about taking uribel also for symptom relief since the pain is affecting my ability to work?
Answered by Dr. G.Srinivasan 12 hours later
Brief Answer: Kindly complete the course of cipro--------------- Detailed Answer: Welcome back. Yes please, complete the course of cipro. It is too early to talk about stricture, but edema is possible due to manipulation of the ureter by instrumentation. You may take Uribel also. Wish you good health, Regards Dr Srinivasan
Follow-up: Suffering from pain in penis and kidney after laser lithotripsy for kidney stone problem. What could it be? 2 hours later
ok so today I had a couple hour episode of nausea. No vomiting, but nausea and fatigue. No fever. Same pain, though sometimes sharp, and the feeling of needing to urinate a lot. Seems like it may be a small stone still passing, but did not show up on CT. I assume it's possible they did not see small stone on CT scan? I have had that happen a couple times since May of this year. On CT scan has a stone, then 3 weeks later, another one that was not there, is there and grown to 3mm or so. Seems sometimes stones may "hide" from view on CT scans. Is this your experience also? Regards, XXXXXXX
Answered by Dr. G.Srinivasan 3 hours later
Brief Answer: Small stones can be missed on CT. Detailed Answer: Dear Mr XXXXXXX Welcome back. CT scans can miss small stones especially those in the ureter. So, since you had similar episodes, small stone in the ureter is quite possible. The treatment would be to completed the course of antibiotics and add tamsulosin, as it can help expel small stones. Truly Dr Srinivasan G