This page has only one article because I have not been active enough in getting surgeons to write for us. It is very good, and covers a leading surgical modality. I need to get more of them.
Ureteroscopy – An excellent review of this modern technique
Percutaneous Nephrolithotomy – An equally excellent review of this complex stone surgery
I am interested in learning about kidney nephrosis and why and how it occurs and how to repair. I have had kidney pain and have previously had multiple lithotripsy. This time round the doctor performed a CT scan and noted I have an approximately .9 mm stone in my ureter half way between the kidney and bladder. The doctor says uretoscopy is the only was as lithotripsy will not achieve a good result as the stone is in an are of the ureter behind the pelvis. I am not In pain right now but the CT scan showed that the kidney is moderate nehprosis. Currently the doctor says we can try and wait for the stone to pass or do the uretroscopy. He thinks it is is a low chance of passing even if I do not have symptoms and if left too long can cause permanent kidney damage. I am not sure what to do. Should I wait a couple of weeks to see if it passes or go ahead with the surgery.
Hi Mihir, You have an obstructed kidney, and the name is hydronephrosis meaning that fluid has collected behind the obstruction and is dilating the structures of the kidney. If left untreated, this can injure the kidney and reduce its function, Your physician is right and I agree with him that it is best to remove this stone before kidney damage occurs. I would not wait weeks but rather let him remove it as soon as he can. Regards, Fred Coe
5 days ago I had rIght sIde ureteroscopy laser and ESWL for a 9 mm mId ureter and 7mm in kidney w stent placement causing mod-severe hydronephrosis. I will address a 7 mm in left kidney at another time. I have been properly diagnosed via previous ureteroscopy for MSK. Stone removal has lessened with diet,and meds to approx every 2 years. I have taken Jill’s class and follow it. Hydration is more than adequate. As per this week’s procedure, I have developed numbness in right thigh. I have read thIs may likely be due to the ESWL nerve injury. is this likely and will the numbness go away?
Dear Dr Coe, I had a CT scan done with the following results:
– Both kidneys are identified in their respective renal fossa and appear normal in size and contour with normal parenchymal pattern.
-Radiodense stone measuring about 4 mm (HU377) noted at the lower pole of
the left kidney.
-Radiodense stone about 6 mm noted at the proximal part of left ureter causing
mild hydronephrosis.
-no fluid collection or abnormal fat stranding of the peri or para nephric spaces noted.
My urologist has prescribed tamsulosin and a painkiller. It’s a week and a half now and since the 6mm stone hasn’t passed, he’s suggesting ureteroscopy w laser litho next week. Similar to Mihir above, should I wait a couple of weeks to see if it passes or go ahead with the surgery. Thank you for your time
Hi Dd, I would go ahead. Obstruction is not good for a kidney. The low HU units at 377 are suggestive of a uric acid stone. Be sure the stone is analyzed because uric acid stones have special treatments. Regards, Fred Coe
Dear Dr Coe,
Recently I went for a preventive CT scan of the heart and while everything was normal, there was finding of bi lateral non obstructing kidney stones measuring 8mm and 4 mm. There are no symptoms and they don’t bother me currently.
An xray last week confirmed the same findings. Because I don’t have symptoms and not knowing how long they have been sitting there, I am a little reluctant to have them removed through a procedure and go through all the suffering and pain . I have been reading online and quite stressed out knowing experiences given my low pain tolerance level.
Is there a way to say how long they can remain stuck inside my kidney ? Should I go out and get them treated prophylactically or wait our for them to either pass or cause symptoms before starting treatment ?
In theory , can one continue to live with stones in the kidney as long as they aren’t growing and remain non obstructing ?
Many thanks,
Vik
Hi Vic, I see no need to remove stones that are not causing pain, obstruction, bleeding or infection. But you have stones and should find out why. More could form. Regards, Fred Coe
Hi Dr. Coe,
I was told that I have two kidney stones–one 4.8mm one in the right kidney, and one 3mm in the left. My urologist has said that if I wished to opt for a ureteroscopy, I could do so. The stones frighten me, as I’ve already passed a 2mm and a 3mm, and the pain is absolutely beyond my threshold. Can stones be removed even if they aren’t actively passing? I was recently in the ER and while the right kidney stone wasn’t actively getting ready to pass, for some reason, I still had slight hydronephrosis in that right kidney which somehow resolved itself. I feel like I have two ticking time bombs waiting to explode and I’m scared of the pain the almost-5mm stone may cause if and when it decides to pass.
I’d love to hear your thoughts.
-Emily
Hi Emily L., About stones in place, everything depends on how one feels. If they are not causing obstruction, bleeding of consequence, infection, or pain, removal is not required. But some people do not like the feeling that they are there and want them removed – that is a personal and understandable view. What I am more fussy about is that you be evaluated for cause and treated to prevent more stones. See if this article helps with that. Regards, Fred Coe
Hi Dr Coe-
Thank you for providing such extensive education regarding kidney stones. I’m a 58 yr old female and have been producing stones since my mid 20s, with the stones becoming more frequent in the past couple of years. I had a lithotripsy about a month ago to remove a 4mm calcium oxalate stone. I’ve continued to have pain in both kidneys and a subsequent ultrasound has revealed multiple stones in my left kidney over 5 mm and one in my right kidney at 5 mm.
Do you do consultations? I’m concerned I have permanent damage to my kidneys as I have extreme fatigue and chronic bilateral pain in my kidney area and have had these ever since my kidney pain started 2 months ago. I would like to know how best to address the existing stones. I was also very bothered to see my previous surgeon recommended waiting for surgery when the right kidney had moderate hydronephrosis, althoughI didn’t understand the significance of waiting at the time. I’m working on diet with Jill’s plan. Any guidance you could provide would be appreciated. Thank you.
Dr Coe: I was diagnosed with a 2.4CM (not mm) stone in December 2023. This was the largest of several. I have undergone two lithotripsy procedures and a ureteroscopic stone removal with laser. I still have two 1cm stones. I don’t know how much longer I can take this. What should I do other than jumping off a bridge. I am a 65 yr old female.
Hi Linda, Please, no bridge. What are the stones made of? Start there! Without knowing that no one can be very helpful. Fred
PS. This is the fourth time I have had kidney stones. All four horrendous experiences. My stones were just analyzed this month for the first time.
Calculi Composition
Value
Percentage (Represents the % composition)
Ca Oxalate,Dihydrate 20%
Ca Hydrogen Phos.80%
Do I need a new urologist?
LR
Hi Linda, Ah, the composition: calcium hydrogen phosphate is brushite and that is a nasty crystal that forms rapidly and makes large stones. The cause is usually high urine calcium and pH and low urine citrate. You would benefit from complete metabolic evaluation to find the cause and extinguish it (them). REgards, Fred Coe