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Does Calculus Pass Naturally Or Should It Be Removed Surgically?
Hi Dr.. My wife (32 years) was diagnosed with a calculus in her left kidney last year. After a few painful episodes, the same calculus (6 mm) is now shown to be in the vesico-ureteric junction in USG KUB. She has had a urine infection, and currently on antibiotics . My question is does this type of calculus pass naturally, or should we go for surgical removal without any delay? Thanks
Tue, 25 Feb 2014
Hello
Thanks for writing to us with your health concern.
In general, a calculus that is less than 10 mm is always given a trial for natural removal.
The size of the calculus that your wife has ( 6 mm ) is quite small.
Normally, this sized calculus will easily pass through into the urine and get excreted.
Of course, the type of stones matter, with some stones being more resistant to treatment.
In your case, the stone has already migrated downwards, from the kidney and is now at the VUJ ( vesico ureteric junction ).
In all likelihood it would pass from there, through the ureters and hence outside through the bladder.
The problem is that the passage and peristalsis of the calculus, however small, would lead to a great amount of pain and discomfort.
There is no way to predict it, it might be painless also.
Calculus removal surgical would be indicated in the following situations -
1. Painful passage.
2. Recurrent infections of the type you mention, which might scar her kidneys forever.
Drink atleast 5 litres of fluids daily to facilitate stone removal.
All the best
Take care.
Thanks for writing to us with your health concern.
In general, a calculus that is less than 10 mm is always given a trial for natural removal.
The size of the calculus that your wife has ( 6 mm ) is quite small.
Normally, this sized calculus will easily pass through into the urine and get excreted.
Of course, the type of stones matter, with some stones being more resistant to treatment.
In your case, the stone has already migrated downwards, from the kidney and is now at the VUJ ( vesico ureteric junction ).
In all likelihood it would pass from there, through the ureters and hence outside through the bladder.
The problem is that the passage and peristalsis of the calculus, however small, would lead to a great amount of pain and discomfort.
There is no way to predict it, it might be painless also.
Calculus removal surgical would be indicated in the following situations -
1. Painful passage.
2. Recurrent infections of the type you mention, which might scar her kidneys forever.
Drink atleast 5 litres of fluids daily to facilitate stone removal.
All the best
Take care.
I find this answer helpful
Hi,
Kidney is connected to ureter by pelvis which is broader than ureter (approx 5mm).and then bladder finally urethra which are broader than ureter . So calculus of 5mm dia can pass but with difficulty. It has been found calculus of bigger size than this has also passed but with severe pain n sometimes with complications like stricture..... .
So calculus has passed till broader area(PUJ) n now narrow passage starts . so its hard to predict wheter it ll pass or not(probably not) n latter it may have hydronephrosis n pressure effect on kidney .
Therefore in my opinion you can go for ESWL with jj stenting (No incision made in this procedure) if feasible . There is chance of recurrence so have plenty of fluids latter n avoid food according to stone biopsy.
Thanks n regards
Kidney is connected to ureter by pelvis which is broader than ureter (approx 5mm).and then bladder finally urethra which are broader than ureter . So calculus of 5mm dia can pass but with difficulty. It has been found calculus of bigger size than this has also passed but with severe pain n sometimes with complications like stricture..... .
So calculus has passed till broader area(PUJ) n now narrow passage starts . so its hard to predict wheter it ll pass or not(probably not) n latter it may have hydronephrosis n pressure effect on kidney .
Therefore in my opinion you can go for ESWL with jj stenting (No incision made in this procedure) if feasible . There is chance of recurrence so have plenty of fluids latter n avoid food according to stone biopsy.
Thanks n regards
I find this answer helpful
Hi,
Kidney is connected to ureter by pelvis which is broader than ureter (approx 5mm).and then bladder finally urethra which are broader than ureter . So calculus of 5mm dia can pass but with difficulty. It has been found calculus of bigger size than this has also passed but with severe pain n sometimes with complications like stricture..... .
So calculus has passed till broader area(PUJ) n now narrow passage starts . so its hard to predict wheter it ll pass or not(probably not) n latter it may have hydronephrosis n pressure effect on kidney .
Therefore in my opinion you can go for ESWL with jj stenting (No incision made in this procedure) if feasible . There is chance of recurrence so have plenty of fluids latter n avoid food according to stone biopsy.
Thanks n regards
Kidney is connected to ureter by pelvis which is broader than ureter (approx 5mm).and then bladder finally urethra which are broader than ureter . So calculus of 5mm dia can pass but with difficulty. It has been found calculus of bigger size than this has also passed but with severe pain n sometimes with complications like stricture..... .
So calculus has passed till broader area(PUJ) n now narrow passage starts . so its hard to predict wheter it ll pass or not(probably not) n latter it may have hydronephrosis n pressure effect on kidney .
Therefore in my opinion you can go for ESWL with jj stenting (No incision made in this procedure) if feasible . There is chance of recurrence so have plenty of fluids latter n avoid food according to stone biopsy.
Thanks n regards
I find this answer helpful
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