is there a way to help a stone pass on it's own?

[Steve-West]

Posted by Steve West on July 30, 1999 at 09:26:09
A little over a week ago, I got a kidney stone on my left side.  I had one on my right side about eight years ago, and this pain was a bit more intense (like a claw hammer ripping my insides apart!).  That last stone was about 4mm in diameter, so this one is likely about that large.  That one passed on it's own.
In the ER last week, they told me that the results of the IVP suggested that the stone is near the opening to the bladder and that they couldn't see it directly.
My doctor has given me two weeks to let it pass on it's own before he refers me to a urologist (and that period is almost up).  My GP's orders are to drink tons of water.  Alas, the stone hasn't seemed to move.  Is there anything else I can do to perhaps relax the constriction of the ureter and pass this thing.
The last few days, I've tried something a little different to no avail.  I drink about 1/2 gallon of water and follow it with a cup of coffee, and then continue to drink water.  That flushes an enormous amount of water through my system, but hasn't moved the stone.  I do note that I have continued to pass blood during this time, so perhaps the thing is moving ever so slightly?
I also noticed that the IVP contrast had the effect of providing pressure on the stone that moved it slightly.  Is there something I can drink or eat that would cause some additional pressure in the clogged ureter to perhaps push the stone into the bladder?
Oh yes, and how long can we let things proceed naturally before the kidney has been shut down for so long that it starts to refuse to function after the stone is removed?
thanks much,
swest

Posted by HFHS M.D.-JS on August 05, 1999 at 10:40:50

Thank you for your inquiry.  Depending on the size of the kidney stone there is high probability of it passing spontaneously.  The cut off  has been around 5 mm in size predicting a 90%  of the stone passing without intervention.  The location of the stone also helps predict the likelihood of spontaneous passage.   Stones near the bladder(ureterovesicle junction) have a higher chance of passing in a timely fashion(2 week) than stones in the mid ureter or upper ureter.It is important to perform an IVP to make sure the ureter is not totally obstructed by the stone.  If there is dilatation of the ureter up to the kidney, it is strong evidence of obstruction most likely from a ureteral calculi.  As long as some of the contrast is seen distal to the stone there is not total obstruction.  With small stones  2 liters a day.  Unfortunately there are no medications on the market to help speed up the process.  As long as your pain is under control, no fever/chills/ vomiting the best treatment is conservative.  To cause damage to the kidney it has been shown that total obstruction  at  4 weeks will damage the function of the kidney.  If you have not passed the stone at 2-3 weeks it would not be unreasonable to intervene surgically to “basket” the stone and pull it down.  Please consult your physician if  you have further questions.
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).
Sincerely,
HFHS M.D.-JS
*keyword:ureteral stone