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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Small Stone Found In Ureter. Will It Pass Naturally? Will It Lead To Less Blood Count, Loss Of Appetite?

Hello, I have CMML and systemic mastocytosis (59 yrs old) - and have recently been diagnosed with kidney stones . A CT scan on Friday showed a 1cm stone in the ureter . I have been told that this is smallish and should pass naturally. I am still waiting for an appointment with a urologist . I am concerned that the stone may be too big to pass and may end up contributing to a fall in red blood counts ( I m having chemo at the moment) and loss of appetite and sickness. Any advice would very welcome, especially if a stone of that size is likely to pass. Thank you!
Tue, 10 Jul 2012
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General & Family Physician,  's  Response
Hi Mr. Jo,

Very sorry to hear about your condition. Renal stones can be very painful. Being a patient of CML and on chemotheapy increases the risk of renal stones. Since you already have been worked up for it and know the size of the stone, the next step is treatment. In addition to analgesics (to relieve your pain), drink a lot of water. Regarding the size of the stone, if the size is 1cm (and not 1mm. I am assuming that 1 cm is not a typo), then it is unlikely to pass out on its own and you may need lithotripsy ( a procedure to remove stone upto the size 2 cm.). Stones that are less than 5 mm in size can pass on their own and the patient can be out on plenty if fluids, analgesics and observation.

In addition to this, you might benefit from Stone analysis, once it passes;serum calcium, uric acid, parathormone, oxalate, magnesium and phosphate level or; 24 hours urine analysis for volume, uric acid, parathormone, oxalate, citrate, cystine, pH, uric acid, magnesium and phosphate. These tests on stone, serum and urine would help identify the cause of stone formation and your diet can be modified as well as other preventive measures, such as optimizing the pH of your urine can be taken accordingly.

To summarize, in your condition, I would recommend to confirm with your doctor the size of stone. If it is 1 cm ( and not 1 mm which is greater than the cut off of 5mm), you may need lithotripsy for the stone removal. You may also want to keep a track of how your kidneys are doing. A lot of times, stone obstruction result in hydronephrosis which is reversible once the obstruction is removed.

Hope that helps.

Take care and be well.
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Small Stone Found In Ureter. Will It Pass Naturally? Will It Lead To Less Blood Count, Loss Of Appetite?

Hi Mr. Jo, Very sorry to hear about your condition. Renal stones can be very painful. Being a patient of CML and on chemotheapy increases the risk of renal stones. Since you already have been worked up for it and know the size of the stone, the next step is treatment. In addition to analgesics (to relieve your pain), drink a lot of water. Regarding the size of the stone, if the size is 1cm (and not 1mm. I am assuming that 1 cm is not a typo), then it is unlikely to pass out on its own and you may need lithotripsy ( a procedure to remove stone upto the size 2 cm.). Stones that are less than 5 mm in size can pass on their own and the patient can be out on plenty if fluids, analgesics and observation. In addition to this, you might benefit from Stone analysis, once it passes;serum calcium, uric acid, parathormone, oxalate, magnesium and phosphate level or; 24 hours urine analysis for volume, uric acid, parathormone, oxalate, citrate, cystine, pH, uric acid, magnesium and phosphate. These tests on stone, serum and urine would help identify the cause of stone formation and your diet can be modified as well as other preventive measures, such as optimizing the pH of your urine can be taken accordingly. To summarize, in your condition, I would recommend to confirm with your doctor the size of stone. If it is 1 cm ( and not 1 mm which is greater than the cut off of 5mm), you may need lithotripsy for the stone removal. You may also want to keep a track of how your kidneys are doing. A lot of times, stone obstruction result in hydronephrosis which is reversible once the obstruction is removed. Hope that helps. Take care and be well.