Procedure to remove Kidney Stones

  : Hi Doctors,
  : Hoping you'd be so kind as to answer a few more questions for me.  I have a neurogenic bladder, no urgency am not able to void on my own. I self cath about 8 times per day. My goal is to have less than 500CC at a time.  Have chronic UTI's and also kidney infections.  Had an IVP done about a month ago and it showed a small stone right where the ureter curves.  Dr. did a cystoscopy and  something else to remove stone with a cage. Once he got in there, he found no stone at that loction, but found a pocket instead. (cant remember name he gave me) Said the reason it looked like a stone was that this pocket (hole) collects urine and during the IVP, it caught a bunch of dye and trapped it which made the shadow appear.  Wasnt able to get more info from Dr. because I had just woken from surgery and now he is out for a month.  My PCP told me that they would most likely do a surgery to cut out this pocket and that this might cure the infections because bacteria would no longer grow there if this pocket isnt there to collect urine.  My questions are as follows:
  : 1.  Have you ever heard of this, and if so is it common?
  : 2.  What does the procedure involve?  Scope or actual surgery?  If surgery, do they cut on the abdomen or the back?
  : 3.  Does this sound correct to you that this could solve my chronic infection problem?
  : 4.  How long does one stay in the hospital after this procedure, and how long for recovery?
  :  I do understand that your answers will be in general terms and you cant get specific since you havent examined me. Thank you in advance for your help, your forum is wonderful.
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  Dear Whims,
   Pain with urination (dysuria) can occur due to urinary tract infection or bladder inflammation. I assume that your urine is uninfected since you said the situation is a mystery to you and your doctor. Urinary tract infections are the most common cause of the symptoms you describe. Other causes include bladder stones, ureteral stones, and interstitial cystitis
   Bladder stones are uncommon in women particularly young women with sterile urine. They can cause slowing of the urine stream and forcing to urinate. Though rare, a urachal cyst might be a consideration.
   Ureteral stones can cause urgency and frequency with small volumes and yet the urinalysis is clear.
  You might also consider a problem outside of the urinary tract, such as spastic bowel or diverticulitis.
   Interstitial cystitis is a condition characterized by sterile urination. Patients have frequent urge to urinate, pain with urination and low volumes with each void. This disease can be quite debilitating to patients with it. It is a diagnosis of exclusion after others are ruled out.
   It sounds as though you need to see a urologist.
   This information is provided for general medical education 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).
  HFHS MD-KR
  *keyword: dysuria, voiding dysfunction, ureteral stones
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Dear DeeDee,
Urinary tract infections can be caused by a number of problems. These include catheterizations, stone disease, compromised immune status, urethral and bladder diverticuli and hospitalization. The condition you describe sounds like a bladder diverticulum. This is an outpouching of the lining of the bladder through the muscle. This pocket collects  urine which does not drain well and can become chronically infected. In your case, the intermittent catheterizations colonize your bladder with bacteria which can subsequently infect the diverticulum.
The treatment is surgical. There are two potential approaches to treatment. The first involves removal of the diverticulum through a cystoscope. This method is the least invasive but not as definitively successful as open surgery. Also depending on the size and position of the diverticulum, this method is not always  feasible. Open surgery is the mainstay of treatment. The abdomen is opened through an incision from the belly button to the pubic bone. The bladder is opened and the diverticulum is excised. The bladder is then resewn together. A catheter is left in the bladder until the incisions heal.
The other possibility is that  you have a ureteral diverticulum. This is quite uncommon and would require careful evaluation to decide if removal would affect your urinary tract infections. would affect your urine infections.
This information is provided for general medical education 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).
HFHS MD-KR
*keyword : bladder diverticulum, ureteral diverticulm