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Urology Community
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Nonobstructing kidney stone
by ekean, Jul 20, 2008 07:26PM
I had CT scan that revealed a 7mm nonobstructing right renal hilar stone. The only symptom I have is blood in my urine (gross hematuria) - no other pain at all. Thank GOD!!! My family has a history of stones and I have at least seen how painful it can be.
So far, all I have seen is my internal medical doc. I plan on getting an appointment with a urologist tomorrow to find out more options.
I have heard that nonobstructive stones may never become a problem but does the appearance of blood mean that the stone is moving or getting ready to work it's way to the urethra? I would imagine that would be where the "fun" would begin.
I had some blood in my urine a few weeks ago - one time. I did nothing about it. Then last week had it 2 days in a row - almost all the time and thats when I went to the doc. Then went 3 days of clear urine, then one time with blood, then clear again.
So far, all I have seen is my internal medical doc. I plan on getting an appointment with a urologist tomorrow to find out more options.
I have heard that nonobstructive stones may never become a problem but does the appearance of blood mean that the stone is moving or getting ready to work it's way to the urethra? I would imagine that would be where the "fun" would begin.
I had some blood in my urine a few weeks ago - one time. I did nothing about it. Then last week had it 2 days in a row - almost all the time and thats when I went to the doc. Then went 3 days of clear urine, then one time with blood, then clear again.
Post Comment
"Nonobstructing stones produce no symptoms or signs apart from hematuria. Stone passage produces renal colic that usually begins as a mild discomfort and progresses to a plateau of extreme severity over 30–60 minutes. If the stone obstructs the uretero-pelvic junction, pain localizes to the flank; as the stone moves down the ureter, pain moves downward and anterior. Stones at the uretero-vesicular junction often cause dysuria and urinary frequency mistaken for infection. Colic is independent of body position or motion and is described as a boring or burning sensation associated with nausea and vomiting. Stones less than 5 mm in diameter have a high chance of passage; those of 5–7 mm have a modest chance (50%) of passage, and those greater than 7 mm almost always require urological intervention"
http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1236703
Nonobstructive stones can predispose to infection and cause renal damage.
It would be best to discuss options for having the stone removed when you meet with your urologist.
Meanwhile, ensure that you keep hydration high with fluid intake over 2000 ml and pass urine as frequently as you feel the urge.
Reducing salt in diet has been known to prevent the recurrence of stones.
D keep us posted on your doubts and progress.
Regards
Said the stone is in the best place possible for this procedure rather than waiting to let it get stuck in the ureter and going through the pain.
Thanks for your response!
Any advice?
"The primary treatments are to alkalinize (citrate or bicarbonate) and dilute (large water intake) the urine. Sodium urate is 15 times more soluble than uric acid. At a urine pH of 6.8, 10 times as much sodium urate as uric acid is present. At a urine pH of 7.8, 100 times as much urate as uric acid is present"
"Surgical treatments may include ureteroscopic stone extraction, percutaneous nephrolithotomy, open stone surgery, and extracorporal shock wave lithotripsy.
Stones may need to be removed by a urologist. The technique used depends on stone size and location."
"Hydration is one of the most important dietary issues. The urine should be collected and measured until the quantity of water needed each day is understood. Water intake may need to be greater in the summer and in warm climates.
A diet low in purine (ie, limited quantities of liver, kidney, brains, sweetbreads, fish, poultry, asparagus, spinach, peas, and beans) may aid in lowering the total-body burden of uric acid and other purine metabolites."
"The overall goal of medical treatment is to dissolve formed stones and prevent new stones from forming.
Citrate or bicarbonate is used to alkalinize the urine. Uric acid has 4 ionizable hydrogen ions (positions 1, 3, 7, and 9). Only the hydrogen ion on position 9 (pKa = 5.8) is ionizable at physiologic pH. Sodium urate is 15 times more soluble than uric acid. When pH equals pKa (5.8), uric acid and sodium urate are present in equal quantities. As pH increases, the ratio of sodium urate to uric acid increases. At a pH of 6.8, 10 times more sodium urate is present than uric acid; whereas, at a pH of 7.8, 100 times more sodium urate is present than uric acid"
www.emedicine.com/ped/topic2361.htm
Regards