stuck stone

My IVP test showed a 2 or 3 mm. stone in the left ureter near the bladder. It is not blocking urine flow, but it will not pass.  The ureter started hurting about a month ago, but I am not in any great pain at the moment.  My doctor said the only procedure is laser lithotripsy through the penis while I am asleep in a hospital operating room.  Is this correct?  Also, I have several phleboliths in the left pelvis.  Are they a problem?

[Kevin Pho, MD]

For mid-ureteral stones, the highest stone-free rates and lowest number of required retreatments are associated with ureteroscopy with holmium laser lithotripsy.

For distal ureteral stones, ureteroscopy is the preferred treatment. However, shock wave lithotripsy is the treatment of choice in some centers.

Some investigators feel the treatment of distal ureteral stones may best be managed initially with endoscopic techniques. As excellent results have been obtained with treatment of distal ureteral stones by shock wave lithotripsy, this technique may become the treatment of choice with some clinicians. Failure of both treatment options may require antegrade percutaneous management or (in extremely rare cases) open ureterolithotomy.

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.

Bibliography:
Preminger.  Management of ureteral calculi.  UptoDate, 2004.