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What is the treatment for kidney stones and increasing WBC in urine?

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General & Family Physician
Practicing since : 2009
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Hello, My wife (35 years) has recently did ultrasound, blood test (reports in the attachment) etc. Ultrasound showed few tiny renal calculi (Kidney stone). Doctor prescribed her following medicines, 1. Tablet - Uritop (salt:nitrosurantoin 100 mg) -- 3 times a day for a week) 2. Ayurvedic syrup: Neeri (2 table spoon) -- 3 times a day for a week Doctor also told her to take lots of water (minimum 2.5 L -- which she normally consumes a day). She was told these medicines will break the kidney stone and extra water will wash those out. ------------------------- She recently did a followup test (report attached), surprisingly pus cell count went up, but she is not feeling any abnormalities. She is not taking any medicine currently. What step we should take and how bad it is? I believe my question was mixed up with the other problem she was having. The recent followup lab was for UTI and the report shows pus cell count increased. My question was what steps should be taken for UTI since that is urgent now. Thanks.
Posted Mon, 23 Dec 2013 in Urinary and Bladder Problems
Answered by Dr. Chobufo Ditah 1 hour later
Brief Answer: Culture should be done and sensitivity tested Detailed Answer: Hi and thank you so much for this query. I am so sorry to hear about these kidney stones and the persistent and increasing WBC in her urine. This is rightly suggestive of a UTI. Because she has been treated and no change observed on these exams there are two possibilities. 1, The antibiotic is not well adapted for the germ which has caused the infection. In this case she will need to have her urine cultured to identify whether this is the problem or not. If it is the case, then the new adapted antibiotic would be prescribed. However, if it is not the case,, then see below. 2. If the antibiotic is well adapted fr the germ, then the treatment will first need to be extended over a longer time frame because of the presence of predisposing factors like the kidney stone. If after 14-21day there is no change, then she should be strongly considered for surgical removal of the kidney stones. this is because, the stones harbor and favor growth of germs that persistently infect the urinary system. And because stones have no blood vessels, antibiotics cannot reach there to kill these germs thus creating a safe XXXXXXX for them to stay, multiple and continuous cause infections which in the long run can completely damage the kidneys. Drinking enough water helps with the washing process. just like you bath with water to keep clean, so too increased urine output by drinking much water can help dissolve stones and push the out. The nitrosurantoin(nitrofurantoin) cannot break any stone. It is an antibiotics that is meant to treat the infection only. Only maybe increased fluid intake can help break the stone and not these drugs. I hope the above addresses your query and provides ample information for you to act on. Thank you so much for using our services and I wish you the very best of health. Please, feel free to ask for further information and clarification if need be. NB: I have reviewed the first 2 uploads. the 3/4th could not open. You may want to check if they were correctly uploaded though they would not change the way forward by much. Dr. Ditah, MD
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