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Large kidney stone
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Avatar universal
Large kidney stone
46 year old woman with moderate medical knowledge.Have had right flank pain intermitantly (with motion, pressure to area) subsides when in coil position after 10-20 mins) for about one year. Cat and xray reveal stone slightly >1cm at juncture or kidney and tube. Doctor first mentioned flank surgery to remove.  What are pros cons of this,complications?  I am scheduled 1/18 for the wave thing and am unclear and have questions on this.  Dr. mentioned He would go up with a scope thing blast the stone and leave a shunt in for a week, remove it and see what happens.
  My questions:Why has my kdney not passed stone earlier?  there seems to great chance a zillion fragmented stones won"t pass either.  how wide is the shunt, is it there to make passage of fragments easier, how.  Does Dr.:  Basket stone,then zap it and pull out major parts or does it fragment to distant areas of kidney injuring area and to become seeds stuck as potential seeds for future stones which also won't pass. I now only have two stones, one smaller in upper area of kidney.
  Am tired of pain, family cannot tolerate me down with pain.
Would flank removal be more prudent? Why or why not?
  Appreciate your time, I was pre-med ucla biochem major, maybe
you got the space I never took, deciding I wanted to be a MOTHER.   thank you ,jana  
Dr. prescibed post-op vicodan.  it barely touches pain now, i requested morphine and he laughed.  could i safely take diazepam?
I anticipate excruciating post op pain with that shunt.
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Avatar universal
Dear Jana,

It is highly unlikely that a stone >1cm at the UPJ (ureteropelvic junction) would pass on its own.  Most stones >.5 cm do not pass spontaneously, and they will require some type of urologic intervention.  Different options exist for dealing with large stones such as yours.  ESWL (Extracorporeal Shock Wave Lithotripsy) or PCNL are the two most common modalities for dealing with a stone of this size at the UPJ.  ESWL does not involve an incision like PCNL.  PCNL involves a small flank incision through which a port is placed, and the stone is either broken up with a
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