What is the treatment for urethral stones?
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I have a ureteral stone which was in the upper third of my ureter last week. This week, it is midway. I have had mild to moderate pain which is managed with ibuprofen. My doctor gave me the option of having the stone removed surgically with a stint in place. I had a bladder repair a few years ago (unsuccessful), and I get a lot of bladder infections, so I am not really eager to have a stint. I have two questions: What are the chances of this stone, which is between 8 and 9 mm, passing the rest of the way and out of my body with the same level of pain I have had so far. I don't want to get in a crisis where I am writhing on the floor of the ER begging the doctor to kill me, like my husband did. Plus, I don't want to run into that situation while I am at work. My job would not allow that, and I understand these things can come on quite suddenly. Second, do I HAVE to get a stint? Will anything terrible happen if I ask them to leave out that part?
Posted Tue, 28 Jan 2014 in Urinary and Bladder Problems
Answered by Dr. Manuel C See IV 1 hour later
Brief Answer: 8-9 mm stone would have less than 50% of passage. Detailed Answer: Good Day and thank you for being with Healthcare Magic! Your ureteral stone at the middle third of the ureter with the size of 8 or 9 mm has less than 50% chance of spontaneous passage on its own. The pain might get worst when the stone is at the junction between the ureter and bladder (ureterovesical junction) which is also the most narrow area of the ureter. You are correct in saying that the pain may come anytime and usually without warning. A ureteral stent may be needed depending on how edematous your ureter is right now and during the endoscopic surgery in removing the stone. Having stent placed after the procedure significantly reduces the risk of having some form of pain even after stone removal. There are instances wherein the ureter will still be obstructed even after removal of the obstructing stone because of the edema. Stents are used to prevent this and let the edema subside first. Ureteral stent are generally well tolerated and usually with no or minimal complications. Depending on your urologist the stent may remain in your body for 3 days to 6 weeks. 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
Follow-up: What is the treatment for urethral stones? 35 minutes later
Thank you so much for your reply. I think I will opt for the surgery. Is there anything I can do to minimize the swelling in my ureter now? I am taking Tamsulosin and so far, there is no blockage. Will Tamsulosin help keep the swelling down? I am also drinking 2 - 3 liters of water a day. Anything else I can do to keep my ureters in good shape so I don't have to have a stint? I understand they make you feel like you have a bladder infection. I've had enough of those!
Answered by Dr. Manuel C See IV 42 minutes later
Brief Answer: Tamsulosinwillhelp expel the stone but nt swellng. Detailed Answer: The tamsulosin will help you expel the stone but not help with the swelling. The edema and swelling will be minimized by the use of a pain reliever or NSAIDs like Ibuprofen etc. Majority of patients can tolerate the stent without feeling the irritation. Stents are optional depending on the decision of the urologist during the procedure/ surgery. You may do well in trusting the instinct of your urologist whether to put in a stent or not but you may tell him that you prefer not having a stent if ever possible. 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.