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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Severely Disabled, Had Urethrenoscopy For Stone Removal, Still Some Left And Has Severe Pain, On Morphine. Why ?

Hello Doctor, my daughter is serverly disabled and had a urethrenoscopy procedure on the 2nd may they removed a large stone from her renal pelvis but left 2 still in her kidney as it was too risky to remove them, she is not a good candidate for a PNCL so there isn't anything else they can do. The problem is everytime she urinates she is in excruciating pain where her body literally contorts and it's causing her seizures to increase, she is on a constant high dose of morphine to no avail and now her palliative care doctor is prescribing ketamine and gabapentin. But I want some answers as to why she is in so much pain and not just masking over it with more drugs as she wasn't like this before the procedure ? Many thanks
Tue, 23 Jul 2013
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Critical Care Specialist,  's  Response
Hi thanks for your question.
Your daughter is having kidney stone and biggest one removed through ureteroscope.The increase in pain after procedure could be due to small pieces of stones which broke from main big stone while removing or big stone is crushed to make it into small pieces so that it can be easily removed.These small left over peices of stone try to pass out with urine and cause sever colicky pain.Colicky pain is always very sever and it is due to obstruction of hollow viscus.She might be getting sever colicky pain when these small pieces of stone pass through with urine.The treatment she is reciving is right.She has to be on higer doses of strong pain killer like morphine or ketamine.Once all left over pieces of stone pass away with urine she will have relief frim pain.Advise her to take plenty of water .Re consultation with urologist is advisible.
Hope this answers your question.
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General & Family Physician,  Dr. Manjeth Kumar G's  Response
Hello,
Welcome to healthcaremagic. Usually after Ureterorenoscopy, there is painful spasm of bladder as well as ureter for some days after procedure. infection may painful micturition in some individuals. Renal stones which left after procedure may dislodge and obstruct the ureter may cause the painful urination. All these can cause the Severe painful spasmodic pain. So follow your nephrologist's advice and take care.
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Severely Disabled, Had Urethrenoscopy For Stone Removal, Still Some Left And Has Severe Pain, On Morphine. Why ?

Hi thanks for your question. Your daughter is having kidney stone and biggest one removed through ureteroscope.The increase in pain after procedure could be due to small pieces of stones which broke from main big stone while removing or big stone is crushed to make it into small pieces so that it can be easily removed.These small left over peices of stone try to pass out with urine and cause sever colicky pain.Colicky pain is always very sever and it is due to obstruction of hollow viscus.She might be getting sever colicky pain when these small pieces of stone pass through with urine.The treatment she is reciving is right.She has to be on higer doses of strong pain killer like morphine or ketamine.Once all left over pieces of stone pass away with urine she will have relief frim pain.Advise her to take plenty of water .Re consultation with urologist is advisible. Hope this answers your question.