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Does uretero renoscopy treatment help treat severe pain from kidney stones?

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Posted on Fri, 22 May 2015
Question: This is 21 years old female lady who is complaining of right sided abdominal pain. she is experiencing this pain for the last 1 week. she was treated conservatively with medications but no improvement. Ultrasound abdomen was done which showed 7mm stone impacted in the right uretero-vesical junction causing mild dilatation of right distal and proximal ureter and right kidney fullness. No other abnormalities seen. Treating Surgeon is requesting for Laser Lithotripsy and Stenting.
Please advise if the surgical intervention required at this time or should She need to manage conservatively with Alpha blockers to flush out the stone or Surgical intervention is really necessary at this stage in veiw of international guidelines.
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Answered by Dr. P. T. Patil (1 hour later)
Brief Answer:
You can wait and watch for a week.

Detailed Answer:
Hello
Thanks for query.Based on the facts it appears that she has impacted stone at Rt. U,V Junction causing back pressure changes in Rt kidney and ureter proximal to obstruction .

The criteria to decide about the modality of treatment in such cases is
1) Degree of Hydronephrosis.
2) Severity and frequency of pain .
3) Signs of infection such as pain and vomiting ,

If pain is moderate and tolerable and if there are no signs of infection one can certainly wait and expect for stone (7mm) to pass spontaneously with following regime.
1) Take antibiotics like Ciprofloxacin twice daily.
2) Smooth muscle relaxants like Drotaverine twice daily
3) Anti Spasmodic like Spasmo- Proxyvon twice daily .
4 ) Tomsulosin once daily.
5) Ensure to drink more water

However if there is severe pain ,fever and vomiting one has to get the stone fragmented by doing endoscopic procedure called Uretero Renoscopy with fragmentation of stone to decompress the kidney and to prevent further impending damage to kidney.

Hope I have answered your query ,please feel free to ask if you have more questions I shall be happy to help you
Thanks and Regards.
Dr.Patil.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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Answered by
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Dr. P. T. Patil

Urologist

Practicing since :1971

Answered : 10449 Questions

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Does uretero renoscopy treatment help treat severe pain from kidney stones?

Brief Answer: You can wait and watch for a week. Detailed Answer: Hello Thanks for query.Based on the facts it appears that she has impacted stone at Rt. U,V Junction causing back pressure changes in Rt kidney and ureter proximal to obstruction . The criteria to decide about the modality of treatment in such cases is 1) Degree of Hydronephrosis. 2) Severity and frequency of pain . 3) Signs of infection such as pain and vomiting , If pain is moderate and tolerable and if there are no signs of infection one can certainly wait and expect for stone (7mm) to pass spontaneously with following regime. 1) Take antibiotics like Ciprofloxacin twice daily. 2) Smooth muscle relaxants like Drotaverine twice daily 3) Anti Spasmodic like Spasmo- Proxyvon twice daily . 4 ) Tomsulosin once daily. 5) Ensure to drink more water However if there is severe pain ,fever and vomiting one has to get the stone fragmented by doing endoscopic procedure called Uretero Renoscopy with fragmentation of stone to decompress the kidney and to prevent further impending damage to kidney. Hope I have answered your query ,please feel free to ask if you have more questions I shall be happy to help you Thanks and Regards. Dr.Patil.