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hello doctor, I had a CT scan which shows that there is evidence of mid pole calculus seen of size 6mm on the right kidney. prominence of right renal pelvis and proximal third ureter seen with upper third obstructive ureteric calculus of size 13mm. on the left kidney there is evidence of three tiny calculi seen of sizes 3 to 5mm involving mid pole. please suggest whether URS, DJ stenting or lithotripsy will be better. can consuming only medicines remove the stones.
Asked On : Tue, 9 Apr 2013
Answers:  2 Views:  66
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General & Family Physician 's  Response
Sep 2013
Thanks for the query to H.C.M. Forum.
13 mm stone ,which is in ureter is cause of concern , but one favourable point is that this is in ureter and if forced diuresis , than may be chances of move from its position.
Remaining all calculi may come out any time with drugs.
In my opinion consult a physician and get diuretics therapy under his supervision.
This stone may impact at the base of urethra in penis , if it comes down due to forced diuresis, so urethra may get injury.
Hope I have answered your question.
If further any question I will help.
Good luck.
Answered: Thu, 4 Jul 2013
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  User's Response
Hi, many thanks for the query!
For a 13 mm stone causing obstruction only medicines will not help.
RIRS is one option or Flexible URS can be tried as the stone is in upper third of ureter.
Also, get Metabolic workup & Sr. PTH done if stones are recurring, you can do stone analysis after stones are removed to know the contents & then take appropriate dietary precautions to prevent stone formation in future.
For remaining stones, take anti-spasmodics, pain killers, diuretics, urine alkalizing agents, uric acid synthesis inhibitors like allopurinol (if your Sr. uric acid is raised) with your doctor's opinion.
You should do- Sr. creatinine, Sr. BUN, Sr. Uric acid, X-ray KUB, CBC,
Urine (R/M).
Wish you a good health.
Take care.
Answered: Thu, 4 Jul 2013
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