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Have Hereditary Spastic Paraparesis and kidney stones. Need to find a doctor who can treat this

My husband was diagnosed at Mayo Clinic, about twenty years ago, with Hereditary Spastic Paraparesis. He has been troubled with kidney stones for longer than that. I understand that there is a correlation between the two. I am looking for a doctor who can treat his condition. I live in Northern Indiana, and there are no doctors in this area who even knows anything about his disease. I am willing to travel. I just need some treatment options.
Asked On : Mon, 8 Apr 2013
Answers:  1 Views:  36
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Pathologist and Microbiologist 's  Response
Hello and welcome to HCM,

A long history of kidney stones along with hereditary spastic paraparesis may be related to each other.
The spastic paraparesis can affect the smooth muscle of the bladder also.
Retention of urine for long periods of time can cause infections of the urinary tract and recurrent stones.
You need to undergo a couple of investigations.
A urine examination is the first investigation. It will identify the type of stone in the urinary tract and presence/ absence of urinary tract infection.
If there is any evidence of infection, an urine culture needs to be done.Appropriate antibiotics need to be given after getting the culture report.
A pevic ultrasound will help to identify any structural abnormality of the urinary tract.
Some structural abnormalities cause recurrent stone formation.
A cystogram/ dynamic bladder study is next investigation. This investigation will pick up the cause of urinary retention (if present) and hence recurrent stone formation.
After diagnosing the cause of recurrent stone formation, treatment has to be done.
Treatment depends on the size and site of the stone.
It may be through lithotripsy, nephrostomy or open surgery.
If the kidney is damaged to a large extent (hydronephrosis- dilated and damaged kidney) it may have to be removed.

Consult an urosurgeon for further management.
Thanks and take care
Dr Shailja Puri Wahal

Answered: Fri, 5 Jul 2013
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