one month after discovering stone....what now

Condensed version: 60-year-old female, overall good health, long history of chronic UTI and hematuria  Pain led me to ER on Dec. 26, where a 1-2 mm stone (Right proximal ureter with mild bilateral hydronephrosis) was discovered. Followed up with urologist a few days later. We agreed on pushing fluids, straining urine, etc. As of repeat CT scan today, Jan. 22, stone has not moved. Pain still comes and goes, but isn't disabling. Vomiting is not an issue, although I do find myself to be pretty consistently, but only slightly, nauseated. Do I stand a chance of avoiding surgery? Do I stand a chance of avoiding a stent if surgery is necessary? I see doc day after tomorrow. Just trying to mentally prepare myself for the inevitable. Why in the world won't my body expel such a small stone? (Ha. How much more can I whine?)

[David Rudnick, M.D.]

Yes, you do stand a chance of passing it without surgery.  If you aren't taking Flomax (tamsulosin), you might ask your doctor for it -- it dilates the muscles of the distal ureter and helps stones pass quicker.

If you were my patient and needed ureteroscopy, I would not be likely to leave a stent.  Studies show that in an uncomplicated ureteroscopy, a stent is probably not needed.

[memaw2287]

Thank you for your response. I neglected to add that I have been taking tamsulosin since the stone was discovered.  My uro is not one to jump into procedures, particularly invasive ones, until we've tried everything else so maybe it can still be avoided. Thank you for the encouragement.

[memaw2287]

Just as a follow up - Stupid Stone, as it came to be known, is finally gone. IVP normal. Urologist has followed up with blood work and 24-hour urine collection.I have my blood work results from the lab, but make no attempt to interpret them. That's my doctor's job and I see him next week to review everything. Glucose BUN, Creatinine, eGFT, Sodium, Potassium, Chloride, Carbon Dioxide Calcium and Uric Acid all in normal range. Parathyroid in normal range, Hyperparathyroidism - low, Primary - normal, Secondary - high, Tertiary - High, Non-Parathyroid Hypercalcemia - low. Calcium - high end of normal range.

24-Hour Urine results not back yet.

eGFR down just a touch from last May - 92 to 88. Not worrisome at all to me. I see nephrologist in April for check up anyway. Again, it's his job to watch that for me.

In the meantime, I just keep pushing water because it's the best thing I know to do! :-)

[David Rudnick, M.D.]

Glad its gone. I agree with the lab work your doctor has ordered.