FarellG58 Asked :
My doctor has just confirmed that I have an 8mm kidney stone in my right kidney and he has asked me to come in to discuss procedures to remove it. I am concerned because I have had calcium stones previously but it has never been this big. Up till now I have never needed any surgery to remove it and it passed out with medication.
I have read that large kidney stones can be dissolved and passed out and I would rather go down this road. I am still urinating although it is reduced and the pain is very bad but I would rather manage with the pain than go for surgery.
What are my options if I do not want to have surgery? My other concern is that in the past when I passed out the stones, I had a lot of pain for some 2 weeks after that and I could not go into work. Will this be worse now that I have such a big stone?
This question was posted under the Kidney Stone Medication, Drugs to Dissolve and for Passing Stones article.
Any response by the Health Hype team does not constitute a medical consultation and the advice should be viewed purely as a guide. Always consult with your doctor before making any changes to your current treatment program. The information provided in this article is not an authoritative resource on the subject matter and solely intends to guide the reader based on the questions asked and information provided.
Dr. Chris Answered :
You should discuss your options with your doctor as he is aware of your current health status, past medical history and other contributing factors. 90% of stones less than 4mm will pass out spontaneously but less than 10% of stones larger than 6mm will be able to pass out through the urinary tract. An 8mm stone is quite large and will eventually cause an obstruction within the urinary tract that can lead to serious complications.
Depending on the type of stone, certain medication to dissolve a kidney stone may be able to help reduce the size so that it can pass out on its own without any further treatment. However, there are multiple factors to consider at this stage and since it is a recurrent stone, you obviously have some underlying disorder that is contributing to the development of these stones. That will also be contributing to its growth so any delay may mean that your stone could become larger.
Medication for dissolving a stone will not work overnight and you may require immediate intervention. Therefore drugs may not be an option at this stage. Open surgery for kidney stone removal is rare these days. There are many other treatment options and your doctor may look at ‘blasting’ the stone with shock waves (lithotripsy). The risks with this procedure is minimal and it is quick. Your doctor will explain the entire procedure to you, or any other procedure that he is considering, and you can discuss your concerns with him. Hopefully you are seeing a urologist as cases of kidney stones of this size should be handled by a specialist.
It is also important to see your doctor as soon as you can so that he can conduct other tests if he has not done so as yet. This will assist with diagnosing any underlying condition that is contributing to the development of kidney stones. There are many causes of kidney stones and certain conditions may mean that some drugs for dissolving the stone is contraindicated or may not be effective. This will reduce your options and lithotripsy may be the only viable alternative for dissolving the stones.
The pain after passing out the kidney stone depends on many factors – the extent of the inflammation or injury of the urinary tract after passing out the stone, other chronic conditions that may be causing the pain or slowing down the healing process and the presence of more than one stone. Your doctor will put you on medication to help relieve the pain and if it is persisting for more than a few days, you should go back and see your doctor.
The size of the stone may not always determine the extent of the pain – size is usually a cause of concern for an obstruction. So it would be difficult to estimate whether the pain will be worse after passing out this stone. Either way, once your doctor conducts the necessary procedure, the stone(s) will be smaller in size. Depending on the procedure, it may be removed. Two weeks is a bit too long to be incapacitated by the pain after passing the stone and this needs to be discussed with your doctor. You do not mention a stent so in the absence of this, recovery should be quicker. Remember that you can still be passing stone fragments for days after the procedure.