[Guest]

My daughter-in-law is 22 weeks pregnant. She has been in pain 3 weeks. doctors (obstetrician urologist) seem reluctant to give her strong enough medicine to control pain just waiting on stone? re any or options?

[Guest]

I'm assuming she has been diagnosed with a stone. Diagnosis of a kidney stone in pregnancy is difficult because of the desire to avoid X-rays as much as possible and ultrasound, which we can use, is not clear or accurate enough in most cases but it is safe so we usually start there. A limited X-ray series is sometimes done because an accurate diagnosis is critical to decide treatment. Unfortunately, many of our options for treating stones become much more dangerous during pregnancy. Increasing the pain medication is not unreasonable and we will often do that more than we would in a non-pregnant person. When this isn't adequate, the next step is usually an internal double-J stent which allows drainage around the stone and gets rid of the pain. Unfortunately, the stone is still there and will need to be dealt with eventually. Also, the stent itself requires a small surgery to place and may be slightly uncomfortable. ESWL or lithotripsy is specifically prohibited during pregnancy!
Stephen W. Leslie, MD FACS
Assistant Clinical Professor
Dept. of Urology
Medical College of Ohio
Founder and Medical Director
Lorain Kidney Stone Research Center
Lorain, Ohio