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How Can One Manage Kidney Stones Which Are Big And Are Not Disintegrated Or Passed Out Despite Taking Diuretics And Fluids?

Posted on Tue, 6 Jun 2023

Question: I am diagnosed with right kidney stone and I am using a few tablets as suggested by doctor. I got this stones for the first time 2 months back in January and they were disintegrated and passed out through urine as told by doctor after 10 daysusage of medicine as he checked it from scan reports.

Now again I am suffering from same problem but with bigger stone this time in the same right kidney. I got admitted into hospital for 2 days where they have given fluids and diuretics but nothing worked out. They have discharged and prescribed few medicines to use for a week time and then repeat scan.

The below is mentioned in the report.
Right Kidney 11.1X4.9Cms with 1 Lower ureteric calculi 8X4mm at vu jcn/mild hydronephrotic

I have also uploaded my scan report and discharge summary in which medicines are given that I am using currently.

Kindly check and suggest me. Your advice will be a great help for me. Thanks in advance!

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

Brief Answer:
Take Tamsulosin once daily and Drotaverine twice daily

Detailed Answer:

Hello,

Based on facts and reports that you have uploaded it seems that pain in the abdomen on the right side that you have got is due to a stone in the right ureter impacted at Ureterovesical Junction causing back pressure changes (Hydronephrosis) in the right kidney.

At the outset let me state that there is no medicine that can disintegrate or dissolve the stone except it is proved to be uric acid stone.

In a given situation, you can expect this stone to pass out through urine spontaneously keeping in mind that no one can predict how long it will take for it to pass out.

Normally, one can expect the stone of a size of 8 mm to pass out spontaneously. You can take the medicines being prescribed by your Urologist. Add medicines like Tamsulosin once daily and Drotaverine twice daily for 10 days and repeat the ultrasound scan after 10 days.

If the situation remains the same and or you get pain, vomiting fever etc., you may need to undergo endoscopic surgery of URS to fragment the stone.

Ensure to drink more water to produce more urine, this will help to flush out the stone.

Hope I have answered your query. Please feel free to ask if you have more questions, I shall be happy to help you.

Thank you.

Regards.
Dr. P. T. Patil
Urologist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Dr. P. T. Patil (4 hours later)

Thanks for your reply.

Please let me know if there is any test/scan to determine what kind of stone it is.

After taking medicine for 10 days and suppose if the situation remains same, can I continue the same medicine or should I undergo surgery compulsory provided there is no pain.

Thanks,
XXXX

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

Brief Answer:
Nature of stone can be determined only on submitting the stone for analysis

Detailed Answer:

Hello,

The nature of the stone can be determined only after the stone is passed out and submitted for analysis in a laboratory so that the recurrence of the stone can be prevented by dietary measures.

If the situation remains the same after 10 days, I would suggest you to get it removed by endoscopic surgery (URS).

Hope I have answered your query.

Thank you.

Regards,
Dr. P. T. Patil
Urologist

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar