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Urology (Expert Forum)
Kidney stone history and surgery questions
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
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.
Kidney stone history and surgery questions
by ramm, Jul 04, 2003 12:00AM
I’m a 50-yr old male awaiting surgery for 2cm dumbbell-shaped stone.
1992: 1st stone. Pain in testicle; blood in urine
2001: Started feeling pain like in ‘92. Went to Dr in Oct’01 complaining of stone. IVP/blood/urine tests inconclusive. Dr thought it was transient pain.
2002: Continued to have twinges thru ‘02.
Jan’03: pain freq/intensity increased. KUB/blood/urine tests inconclusive; though Dr said I had impacted bowel (he later clarified to mean my bowels were full). Rx: Vicadin “in case” it was a stone. Dr not convinced I had stone; he thought bowel troubles (I had minor IBS).
His bowel comment made me think cause was intestinal. I watched diet/bowel movements. Pain always occurred on weekends; thought it was related to dining out Fridays.
Diet didnt matter. Pain continued. Never blood in urine; no urination pain, no headaches/nausea/fever. Pain lasts 1-5 hrs! Vicadin rarely helps.
Mar’03: Couldnt take it any more. Told Dr something wrong & I wanted to know what it is/isn’t. Told him I wanted colonoscopy. He agreed & also ordered CT scan of abdomen.
While awaiting CT, I found I could bring on pain on by exerting myself (eg, doing home maintenance, carpentry). Afterwards, pain would come. To confirm, I went 3 weekends w/ no physical work & had NO PAIN! I then did a weekend of carpentry (lifting/bending) & had PAIN!
Apr’03: CT shows 1.4cm stone; all else OK. So I have confirmed stone, but can’t see urologist for 2 MONTHS – HMOs!
Jun’03: Colonoscopy OK (eat All Bran 5 days/wk for last 4 yrs)
Jun’03: Uro orders IVP, finds 2cm stone. Also something weird w/ UPJ. Nothing specific, just different. Uro thinks piece of stone may be stuck in UPJ or is restricted somehow.
I’m scheduled for surgery on 7/31/03. But, my son is getting married 8/16, so I want to wait til 8/21. Basic surgery plan:
-2 hr surgery scheduled
-Check UPJ, put in stent
-ESWL
-If ESWL doesnt work, PCNL
-1-2 days in hospital depending on what’s done
-1 wk recovery time at home
Recover time sounds ambitious. If I double that, it means a 7/31 surgery w/ 2-wk recovery is just a few days before wedding. Wedding prep would be difficult, so socially, 8/21 is better than 7/31.
But what if I schedule 8/21 & pain returns? Can I get thru another attack? (I guess so cuz I’ve done it so many times) Uro doesnt see problem waiting til 8/21 though he wants to get stone out soon. So can/should I wait til 8/21, what are dangers?
If stent used, what is typical time it’s in?
What type of discomfort w/ stent?
What’s best/worst case for hospital stay & recovery time?
While recovering, can I do computer work?
Why did it take so long for Dr to diagnose problem when I suspected stone from start? Should I have been aggressive about more tests rather than waiting 2 yrs for Dr to realize I was correct? That’s what bugs me most – sensing problem, but not convincing Dr & letting him dissuade me.
I recently read wheat bran can be a cause for stones. Is this likely?
1992: 1st stone. Pain in testicle; blood in urine
2001: Started feeling pain like in ‘92. Went to Dr in Oct’01 complaining of stone. IVP/blood/urine tests inconclusive. Dr thought it was transient pain.
2002: Continued to have twinges thru ‘02.
Jan’03: pain freq/intensity increased. KUB/blood/urine tests inconclusive; though Dr said I had impacted bowel (he later clarified to mean my bowels were full). Rx: Vicadin “in case” it was a stone. Dr not convinced I had stone; he thought bowel troubles (I had minor IBS).
His bowel comment made me think cause was intestinal. I watched diet/bowel movements. Pain always occurred on weekends; thought it was related to dining out Fridays.
Diet didnt matter. Pain continued. Never blood in urine; no urination pain, no headaches/nausea/fever. Pain lasts 1-5 hrs! Vicadin rarely helps.
Mar’03: Couldnt take it any more. Told Dr something wrong & I wanted to know what it is/isn’t. Told him I wanted colonoscopy. He agreed & also ordered CT scan of abdomen.
While awaiting CT, I found I could bring on pain on by exerting myself (eg, doing home maintenance, carpentry). Afterwards, pain would come. To confirm, I went 3 weekends w/ no physical work & had NO PAIN! I then did a weekend of carpentry (lifting/bending) & had PAIN!
Apr’03: CT shows 1.4cm stone; all else OK. So I have confirmed stone, but can’t see urologist for 2 MONTHS – HMOs!
Jun’03: Colonoscopy OK (eat All Bran 5 days/wk for last 4 yrs)
Jun’03: Uro orders IVP, finds 2cm stone. Also something weird w/ UPJ. Nothing specific, just different. Uro thinks piece of stone may be stuck in UPJ or is restricted somehow.
I’m scheduled for surgery on 7/31/03. But, my son is getting married 8/16, so I want to wait til 8/21. Basic surgery plan:
-2 hr surgery scheduled
-Check UPJ, put in stent
-ESWL
-If ESWL doesnt work, PCNL
-1-2 days in hospital depending on what’s done
-1 wk recovery time at home
Recover time sounds ambitious. If I double that, it means a 7/31 surgery w/ 2-wk recovery is just a few days before wedding. Wedding prep would be difficult, so socially, 8/21 is better than 7/31.
But what if I schedule 8/21 & pain returns? Can I get thru another attack? (I guess so cuz I’ve done it so many times) Uro doesnt see problem waiting til 8/21 though he wants to get stone out soon. So can/should I wait til 8/21, what are dangers?
If stent used, what is typical time it’s in?
What type of discomfort w/ stent?
What’s best/worst case for hospital stay & recovery time?
While recovering, can I do computer work?
Why did it take so long for Dr to diagnose problem when I suspected stone from start? Should I have been aggressive about more tests rather than waiting 2 yrs for Dr to realize I was correct? That’s what bugs me most – sensing problem, but not convincing Dr & letting him dissuade me.
I recently read wheat bran can be a cause for stones. Is this likely?
Doctor's Answer
by Kevin Pho, MD, Jul 06, 2003 12:00AM
, Jul 06, 2003 12:00AM
Hello - thanks for asking your question.
1) In PCNL, the nephrostomy tube is typically left in for 1-2 days.
2) There may be continuing discomfort over the kidney that should improve over several weeks. Blood in the urine can continue for two weeks.
3) Hospital stay is generally 2-3 days. As mentioned above, there may be residual kidney pain for several weeks after the procedure. This can be managed with oral pain medications.
4) While recovering, there should be no heavy lifting or straining for 4 weeks. Driving should be avoided until you can do most of the household chores comfortable. Computer work should be ok as long as it doesn't involve heavy lifting.
5) Without examining you, I cannot comment on why it took so long for the doctor to diagnose the stone.
6) Wheat bran can predispose you to forming calcium oxalate stones. If you have recurrent stones, then cutting back on bran can be discussed with your physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
1) In PCNL, the nephrostomy tube is typically left in for 1-2 days.
2) There may be continuing discomfort over the kidney that should improve over several weeks. Blood in the urine can continue for two weeks.
3) Hospital stay is generally 2-3 days. As mentioned above, there may be residual kidney pain for several weeks after the procedure. This can be managed with oral pain medications.
4) While recovering, there should be no heavy lifting or straining for 4 weeks. Driving should be avoided until you can do most of the household chores comfortable. Computer work should be ok as long as it doesn't involve heavy lifting.
5) Without examining you, I cannot comment on why it took so long for the doctor to diagnose the stone.
6) Wheat bran can predispose you to forming calcium oxalate stones. If you have recurrent stones, then cutting back on bran can be discussed with your physician.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Thanks,
Kevin, M.D.
Member Comments (1)
by Veronica425, Nov 05, 2003 12:00AM
To: Kidney Stones
0
by Veronica425, Nov 05, 2003 12:00AM
To: Kidney Stones
0
