Brief Answer:
Right now you might have mild urinary tract infection

Detailed Answer:
Hi XXXX XXXXXXX
Thanks for writing in to us.

I have read through your query in detail.
Your problems appears to be the different reports having findings which are inconsistent.

I will analyze each report as follows

Report 1 done on 05-06-2013 shows
Right kidney 5.5 mm stone in upper pole
Left kidney 6.4 mm stone in lower pole

Report 2 done on 07-09-2013 shows
Right kidney 2 mm stone formation
Left kidney 2 mm stone formation

Report 3 done on 12-02-2015 shows
Right kidney 4.2 mm in upper pole
Left kidney 3.2 mm in upper pole

Report 4 done on 03-03-2015 shows
Right kidney no stone visualized
Left kidney no stone visualized

From the above reports, it is found that there have been small stones in both of your kidneys since 2013. Stones can increase or decrease in size and number with time.

The last scan done on 03-03-2015 might have missed the stones or the stones seen in the scan dated 12-02-2015 were falsely reported. It i not possible for stones to be seen and then disappear within 20 days without treatment and rarely stone from both kidneys can pass out together and that will cause severe pain and you have not written about any problems in the recent one month.

Even if present, the stones are small and not causing any problems. If your kidney function blood tests are normal then you should not worry for the stones.

To confirm the presence of stones in your case, I will suggest a CT scan plain KUB region. This is a detailed investigation and stone up to size 2 mm will be confirmed

The urine report dated 02-03-2015 shows pus cells and RBCs and this might indicate mild urinary tract infection. For this you need to get urine culture and sensitivity test done and get treated if there is infection. If you had severe pain in the last 20 days then it is possible that a stone passed out and caused pus cells and RBCs in urine.

You might choose to follow instructions below to avoid any more stones in your kidneys and to cause the stone to disappear.

DOs for kidney stones
(i) Drinking as much as 1.5 to 2.5 liters a day may help flush out your urinary system. This will also allow small stones to pass through.
(ii) Visit washrooms regularly and empty your bladder when you feel like doing urination.
(iii) Please take fruits like apple, papaya, watermelon, pineapple, sweetlime, bananas and orange, vegetables like, white gourd, ladyfinger, pumpkin, pulses and legumes.
(v) If you have sharp pain then you should consult your doctor and take pain reliever medications under strict supervision.

DONTs for kidney stones
(i) Please avoid holding urine for long intervals.
(ii) Please reduce foods containing oxalates like non veg, vegetables like spinach, tomato, cauliflower, brinjals, nuts like cashew, pista and almonds.
(iii) Decrease extra salt in foods.
(iv) Avoid spicy pickles.
(v) Please eat meat products in normal amounts, avoid eating too much.

Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

---

Brief Answer:
Most likely you have urinary infection

Detailed Answer:
Hi XXXX XXXXXXX
Thanks for writing back with an update.

If you did not have severe pain and are having burning when passing urine then you have urinary infection because there is pus cell and RBCs in urine. Please get urine culture and sensitivity test done and then take treatment for urinary infection which might include a short course of antibiotics. Drink lots of water and visit washroom regularly.

Regarding the credibility on one lab over the other, I am not convinced. As a radiologist myself, there are many reasons for stones not showing on scan. It can happen due to the machine settings, the gas in your abdomen or due to the food you have eaten the day before the scan. Sometimes, it is really difficult to see small stones because of above reasons and then the doctor is unable to see them.

However, please do not worry because the stones are small and not causing any problems.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

---

Brief Answer:
A report saying no stone is likely to be wrong in view of earlier reports

Detailed Answer:
Hi XXXX XXXXXXX
Thanks for writing back with an update.

Keeping in mind the earlier reports, I feel that the possibility of a report saying there is no stone is more likely to be wrong. Also you never experienced severe pain in the last 20 days and after the first scan which can justify the passage of stone leading to non visibility.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

---

Brief Answer:
Please find details below

Detailed Answer:
Hi XXXX XXXXXXX
Thanks for writing back with an update.

Having read through your kidney function test and urine culture reports, I find that everything appears normal.

Therefore there is no risk of any existing kidney problems or urinary infection.

Regarding the urine culture, I would like to clarify if you have taken any antibiotics after our last communication. If you took antibiotics after 05-03-2015 for burning urination and then gave sample for urine culture on 13-03-2015 then most probably any infection would have been treated by the medications.

If you have not taken any antibiotics then the burning urination might be due to hot weather and sweating along with drinking less water. Drinking adequate water to compensate for loss in sweat and carrying a water bottle when you go out in the sun will help in that case.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

---

Brief Answer:
Please consult urologist to know if you have urethritis causing symptoms

Detailed Answer:
Hi XXXX XXXXXXX
Thanks for writing back with an update.

Pain is a sensation that is a dull, continuous and pulling in nature. While burning is a stinging and present usually during passage of urine. Sometimes both sensations occur together and due to subjective nature, it is difficult to say which is more. It entirely depends on the patient and purely based on questioning. It cannot be measured.

Painful sensation or a burning in the morning associated with first urination might be a symptom of urethritis. Urethra is the tube connecting the urinary bladder and penis. This can be due to organisms which are routinely not observed in urine culture. The bacteria include nongonococcal urethritis, chlamydia and trichomonas. Special tests are required for these organisms, and it will help to get an opinion from the urologist before you get it done.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

---