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Diagnosed With 18 Mm Gallstone And 5 Mm Stone In The Ureter. What Can Be Done?

Posted on Fri, 30 Aug 2013

Question: Im 27
I was diagnosed with 18 mm gallstone and 5 mm stone in the end of the ureter.. Gallstone has no symptoms and doesnt hurt. But the stone in the ureter hurts so much.. What do i regarding both?

Answered by Dr. Dr. P. T. Patil (5 hours later)

Brief Answer:
Please read detail answer below.

Detailed Answer:
Hello
Thanks for your query.
You have 18 mm silent stone in the gall bladder and a stone of a size of 5 mm in lower ureter which gives rise to severe pain in abdomen.

The stone in the ureter obstructs the flow of urine from kidney down in to ureter and causes accumulation of urine in to ureter and kidney what is called as Hydroureteronephrosis
.
The pain will not subside unless the urine flow is restored .There are two option for treatment.
1) Your stone being small (5mm) you can certainly wait and watch for few more days and give nature its own chance, so that stone can pass down through normal urinary passage.You can take antibiotics like Ciproflaxacin along with pain killers like spasmoproxyvon twice daily.or
2) Endoscopic( Ureterorenoscopy) fragmentation of stone and make the passage clear so that urine flow will be restored This will help to prevent further damage to the kidney due to impacted stone and will give relief from pain.

As regards gall bladder stone it being silent can leave it alone and may thinkof doing Laproscopic Cholecystectomy later on.

Hope I have answered your query. If you have any more questions please feel free to ask me I shall be happy to help you
Dr.Patil.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. P. T. Patil (1 hour later)

Hi dr.
Thanks a lot for your answer

I went to make the scan today.. Dr said that the stone is now very near to the bladder.. Only 10 mm away from the bladder.. He said that since the stone went all the way to reach this area, it will defenitely fall in the bladder , he gave me the attached medicine to loosen the ureten.. What do u suggest im really worried! Im having a fever now and scared that its related to an infection somewhere in the bladder or ureten.. ?

Answered by Dr. Dr. P. T. Patil (1 hour later)

Brief Answer:
Please read detail answer below

Detailed Answer:
The stone is impacted at Uretero -Vesical Junction which is narrowest part of ureter. I have already said that it is likely to pass down in bladder but one can not say when it will pass down .

.The fever is due to infection of the stagnant urine in the ureter and kidney.
If fever and pain continues even after taking antibiotics you have to consult qualified Urologist for guidance and opinion regarding further treatment.(URS).

The medicine your Dr has prescribed is to relax the ureter which may help to pass the stone down .
Thanks and regards.
Dr.Patil.

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Dr. P. T. Patil (1 hour later)

Ok dr one last question..

The dr told me that it may fall in one week.. Now im worried where does the urine go?? If the stone is blocking the urine since many days ago and he say it will take some days to fall, where does the urine go? It all stays in my kidney since the first day the stone went to my ureter??

Answered by Dr. Dr. P. T. Patil (6 hours later)

Brief Answer:
There will be flow or urine

Detailed Answer:
The passage of urine from kidney to bladder through ureter is not blocked completely so there is still flow of urine through ureter.It is very difficult to predict how long it will take to come out.
Do not worry wait and watch for few more days .
Thanks and regards.
Dr.Patil.

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Above answer was peer-reviewed by : Dr. Raju A.T