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Urology (Expert Forum)
Bladder & Stones
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Bladder & Stones
by Jim__0, Jun 17, 1999 12:00AM
Posted by Jim on June 17, 1999 at 14:52:05
I ignored the symptoms of stones way too long. Partly because I'm a man (men don't go to Doctors) and partly because I had no pain in the kidneys just the bladder. I went wen I obstructed and then passed some stuff. IVP showed a stone in each tube at the neck entering the bladder.
The Urologist went in and cleaned out the bladder. He said it looked like an 80 yr old's. I'm 49. The bladder is so misshapen now (retention is at least 32oz.) that he couldn't get the scope or basket into either tube to go after the stones. He said that nothing can be done through the urethra and that shock wave isn't an option. I think that everything he has mentioned so far has the words external surgery after it. Do you know of any thing else? Maybe something Laprascopicly?
Posted by HFHS M.D.-AK on June 18, 1999 at 14:24:12
Dear Jim,
It is difficult for me to comment on your situation because I was not present at the time your urologist attempted to remove your stones the first time. I agree that shock waves are not an option due to the distal location in the pelvis. Personally, I would perform ureteroscopy and stone basketing and possible Electrohydrolic Lithotripsy or Holmium laser treatment if necessary. I don’t know the size of your stones, nor do I know the location of your stones. Maybe you have a large prostate with a median lobe that doesn’t allow access to the ureteral orifice. Obviously you have some external outlet obstruction or you wouldn’t have the bladder trebeculation you discussed.
I don’t think it would be unreasonable for you to get a second opinion from another urologist to remove your stone endoscopically. If your stones are too difficult to remove through a scope, then an open ureterolithotomy(EXTERNAL SURGERY) would be necessary.
In regards to your bladder, you need to make sure that you empty it completely or you will get infections and it will continue to deteriorate. Talk to your urologist about bladder management and a second opinion. But keep in mind, I don’t know all the facts of your case. and I don’t know why your doctor couldn’t get a scope or basket into the ureters.
Good Luck!
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword: Calculi
