[Jor-el]

Dear Friends,

I recently found this site after being diagnosed with Kidney stones The things I have read here are both scary and infuriating… some of the medical care given by urologists seems criminal.

So I come to you for answers because you have experience. First I will tell you my diagnosis and then the choices I have been offered. I am looking forward to your advice and experience.

During a pre op physical for total knee replacement they found blood in the urine. That led to a Cat scan which showed “3 right and 5 left renal stones.” The largest one in the "lower pole of the right kidney" measure 7 mm in size. The left kidney shows "mild hydronephrosis" (distension of the kidney caused by the accumulation of urine) that is "secondary to a ureteral pelvic junction stone measuring 7-8 mm." That is, it is in the urethra opening. No other stones were identified.

It’s the stone at the opening of the urethra that they want to remove. But so far I am not in much pain. The knee pain is drowning out most of the kidney pain so I had not really noticed it till it was brought to my attention. Occasional sharp back pain is mostly what I am experiencing.

Soooo, I went to a urologist and she said I have three choices;

1. An operation in the side to remove the obstructive stone.
2. a Stint to remove it.
3) Lithotripsy.

She believes the one stone should be dealt with prior to knee surgery and rest later.

After talking to a friend who went thru the stint business I chose Litho. Then I read the Mayo clinic report stating Litho has a correlation with later hypertension and diabetes. I asked the Doc about it and she said that the location of my stone was nowhere near the pancreas so scaring there (the believed cause of later hypertension etc.) was not an issue. I say I asked the doctor but she is impossible to talk to. She relayed the answer thru a nurse.

Then the nurse told me in a sort of low whisper, "Don't think litho will get rid of the stone! It will probably break it up and then you will go thru a lot of pain peeing it out!"

Great. Just what I wanted to hear.

Now it’s your turn, what can you tell me based on your experience with this sort of thing?

1. Anyone had a 7-8 mm stone that was completely pulverized by litho? Is Litho painful?
2. Is the stint removal painful? (She said they just go in and grab it and pull it out and you are on anesthesia anyway)
3. Anyone had the side-cut removal?

Thanks in advance for your answers!

[cathrine001]

The nurse is right -- lithotripsy isn't meant for large stones, or stones in certain places. I had one the size of a pecan that had lithtripsy three times; it left me with a dmaged pancreas (diabetes) and a permanent case of high blood pressure. Lithotripsy works with very small stones, those that are lodged will not respond to lithotripsy. The best option you probably have is a surgical procedure for removal of the stones, either by incision into the kidney; or ureteroscopy with a basket removal. Get a second opinion, and perhaps a third opinion, to make sure all opinions match before making a decision. I fired nine (9) urologists before finding one that I trusted.

If possible, contact Johns Hopkins University and ask for the Urology Clinic; ask to Dr. Matlaga, the Professor of Stone Diseases. He is worth the wait. If you cannot wait, get the 2nd/3rd opinions from urology departments at a major university. How your stones are handled is extremely important.

Get copies off all scans, CTs, ultrasounds, lab work (i.e., blood, urine, etc.) Take all of your records with you and write down everything the doctor tells you, and be sure and ask lots of questions. You have a right to ask anything you like. Don't take no for an answer.