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Suggest Treatment For Reccuring Kidney Stones

Posted on Tue, 8 Apr 2014

Question: If you have a kidney stone in the left side in a spot that is not in the drainage system and is too small to remove by PCNL and is causing a severe amount of pain, what can be done? I have done a 24 he urine and serum. I am on a low oxalate diet and take cholestyramine 2 times a day. I have had 3 PCNL's in 2 years. I have been in pain with this stone for over a year. Any ideas? I have been told to consider a two part surgery over a week to place a guide wire and a week later do a PCNL. The second option is to remove that portion of the kidney.

Answered by Dr. G.Srinivasan (7 hours later)

Brief Answer: Lithotripsy to be considered. Detailed Answer: welcome ti the forum. Thanks for the clear history. Its unfortunate that you are experiencing pain due to recurrence of the stones. I would be happy to guide you and can be done better if some images of the CT or IVP are uploaded. With the info given by you, issues that cross my mind are--- 1. Discuss with your doctor if lithotripsy (extra corporeal) is possible, because stones less than 2 cm can be dealt with this way. 2. If the stone has not reached the collecting system, wait and watch is also advisable as the stone can be approached only when it falls into the collecting system. 3. Discuss with you doctor if stone is the source of pain, because stones in the collecting system or the ureter, CAUSING OBSTRUCTION only can cause pain. So is this stone obstructing? Hope this info is useful to you. Sincerely,

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. G.Srinivasan (8 hours later)

Stone is not affected by eswl. I only hope you get a non-obstructing stones that causes pain because it is possible to get pain without it. The barbaric and out of date teaching needs changed. I have never had an obstructing stone but I can tell you as soon as I have another one. It is in a position at the lower pole of the kidney and can only be reached by a PCNL through my back. This would be the 4th one like that and about the 8th one by ureteroscopy(sp?).

Answered by Dr. G.Srinivasan (4 hours later)

Brief Answer: Need to know the size of stones Detailed Answer: Hi The size of the stone has not been mentioned in the query and the images not posted. I would be better able to help you if you can provide me with these details. Waiting for your reply. Dr Srinivasan

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Above answer was peer-reviewed by : Dr. Vaishalee Punj