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kidney stone / hydronephrosis
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kidney stone / hydronephrosis

I recently had my first bout with a kidney stone (30yr old male).  It started with sudden extreme pain in my right flank.  I was taken to the hospital via ambulance where they verified a 5mm stone.  As there is a limited number of lithotripsy machines in the area, I was in the hospital for about 56 hours before I finally had surgery to install a stent and have the stone broken up.  While I was there I had constant pain and was always on some type of pain killer which also had me not eating for the duration of my stay, aside from the morning after my surgery.  While in the hospital I spoke the the urologist once who told me the pain was caused by pressure on the kidney from the blockage.  Now that I am out of the hospital I have been reading that hydronephrosis should be taken care of immediately as there is a risk of permanent kidney damage.  I have another week before I see the urologist to have my stent out but I am concerned as to why they would have waited to install the stent and what my risks would be for kidney damage.  At one point the urologist mentioned they could put the stent in and do the lithotripsy separately, but that would require two surgeries and he did not really suggest that.  Had I known there was any type of risk to my kidney I would have been happy to have two surgeries.  Since my discharge, aside from discomfort from the stent (mostly trouble sleeping from the urgency feeling), I am feeling better.  I am not sure what symptoms I might have if there was a problem with my kidney, however.  Was a 56 hour wait too long or is this nothing to worry about?  I plan on speaking with the urologist about it (After he removes the stent) but another opinion can be helpful.  Is there any testing that can be done to tell if I have decreased kidney function or is there no way to tell the difference since my left kidney should still be unaffected?  Thanks!
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Hi,
    How are you? Renal colic is a very severe pain that can present suddenly and without warning. It is usually caused by stones in the kidney, renal pelvis or ureter. The pain is caused by dilatation, stretching and spasm of the ureter. It can present with pain, hematuria, dysuria, frequency, urgency etc. Treatment involves conservative or surgical mangement.

Treatment depends on the size of the stone and duration of presence of stone in the urinary tract and complications present. Most symptomatic renal stones are small (less than 5 mm in diameter) and pass spontaneously. Stones larger than 1 cm in diameter usually require surgical intervention. I think in your case they have waited for the stone to pass spontaneously with medical management.

Signs like reduced renal function, fever, complete obstruction of urinary tract can indicate immediate surgical intervention. But in your case none of the above mentioned complications were there so they waited for the stone to pass spontaneously. You can get a ultrasound and kidney function test done to assess the status of the kidney.

I don't think a 56 hour wait could have caused damage to your kidney, because if it had caused you would have had fever, anuria, severe intractable pain, vomitings etc. The stent would help the stones to pass through the ureter as well as maintain the passage in the ureter.
All the best.
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