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Treatment For Kidney Stones
Question: Hi I have symptoms of kidney stones. The flank pain is managable though . CT scan shows 9mm stone stuck in the ureter and dilated left kidney. Should this be treated via surgery/medication or this should pass through urine itself
In year 2008 I had very severe pain in sometimes April. Within 10 days the pain had gone. All i did was excessive drinking of water and fluids. I passed the stones in dec 2008 via urine.
This year the pain started in XXXXXXX 1 2014. But the pain is not bad as year 2008. Slight discomfort. The pain may get worse as the stone has just started to move down the ureter. I am not sure. According to CT scan my left kidney is slightly dilated. It was same situation in 2008.
My questions
Will this pass via urine given the size 9mm.
Should I do some home remedy? Any suggestion on this?
Are there any medications/home remedy available that should help in passing or breaking down the stones?
Is surgery/operation the final solution?
Any other tips or advices I should take heed of?
Brief Answer:
Treatment would depend on where in the ureter.
Detailed Answer:
Good Day and thak you for being with healthcare magic!
if you have intractable flank pain, intractable vomiting or any degree of fever you have to go to the hospital to be admitted. Otherwise you may opt for conservative treatment if the stone is at the middle to distal ureter. The size of the stone is not ideal for medical expulsive therapy but I have seen bigger stones pass out in the same manner smaller stones still stuck In the ureter after treatment.
Options: 1) Conservative / Medical Expulsive therapy - this can be tried out for 2 weeks with fluid intake, and the medicine I usually prescribe for my patient is Tamsulosin 400mcg tablets for two weeks with adequate pain medicine coverage. If the stone is still there after two weeks then that is the time I offer other forms of treatment.
2) ESWL - this is shockwave therapy and is non invasive form of treatment. Soundwaves are produced by a machine outside the body and focused into the stone without any incision or skin violation. Success rate would be 50-80%. This is ideal for stones in the upper ureter.
3) Ureteroscopy - this is minimally invasive but still more invasive than ESWL. This is done in an operating room Suite and under spinal anesthesia. Small instruments are inserted into the urethra ( opening where urine will come out) and the stones will be fragmented using laser fibers then extracted by wire basket extraction. Success rate would be around 90% and recovery is also fast. This is ideal for mid to distal ureteral stones.
I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: WWW.WWWW.WW I would gladly help you. Best wishes.
Regards,
Manuel C. See IV, M.D. DPBU FPUA
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
According to CT Scan stone has left the kidney and entered the ureter. ie Somewhere around the begining of ureter. really far away from the bladder. Does this affect the type of treatment?
Since my left kidney is dialated should I be on some antibiotics. Is there any possibities of infection
Am i expecting more pain as it moves down the ureter? What does your experience say. Can the ureter cater for 9mm stone.
Brief Answer:
Yes treatment will vary depending on location.
Detailed Answer:
If the stone is in the beginning of the ureter or the proximal ureter then chances of spontaneous passage would significantly decrease. Also there will be more pain and spasm as your ureter will try to expel the 9mm stone. Treatment also would vary depending on the expertise that is available to your area and the location. Like what I have pointed out to you ESWL is preferred for upper ureteral stones while ureteroscopy is preferred for mid and distal ureteral stones although you can do ESWL and Ureteroscopy on any location in the ureter.
Dilation of the kidney does not mean you need antibiotics. You will be needing antibiotics if you develop fever meaning there is infection on your obstructed kidney.
You may or may not pass out the 9mm stone depending on your pain tolerance and other factors like the size of your ureter. The narrowest area of the ureter is approximately 3mm only at the junction between the bladder and the ureter.
I hope I have succeeded in providing the information you were looking for. Please feel free to write back to me for any further clarifications at: WWW.WWWW.WW I would gladly help you. Best wishes.
Regards,
Manuel C. See IV, M.D. DPBU FPUA
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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