This all sounds reasonable. Lithotripsy can be done with US guidance on some machines, but most use x-ray. 20 days after URS you should be able to travel. Stents are not comfortable, but I'd say 10% is a reasonable estimate for people who are really miserable with them.
Yes, there is a significant risk of having the stent in this long. Stents can become encrusted and occluded when left in this long and can actually block and PERMANENTLY damage your kidney. They can be difficult to remove if they have been left in this long. You need to get this stent out one way or another.
stones less than 5 mm have a high chance of passing on their own, like 80%, but these numbers allow a month for spontaneous passage. The higher a stone is when it gets caught, the lower its rate of passage, so a 4mm stone in the upper ureter has a lower spontaneous passage rate than a 4mm stone in the distal ureter.
Hopefully you have passed it by now. The urinary symptoms and groin pain you describe are classic for a stone right near the bladder. Most 3mm UVJ stones pass without surgery, and Flomax and fluids are all you can do. If it has not passed, the treatment of choice would probably be ureteroscopy, an endoscopic procedure to break up and remove the stone.
US is not a super accurate way to measure the size of a stone, so I would probably have you get a simple abdominal X-ray. If the stone is truly 4.9mm, it is passable without surgery, and the most effective medication to help it along is called tamsulosin (Flomax).
pregnancy causes changes in body chemistry that can lead to stones. You would need to do a urine chemistry test after your pregnancy ends to find if you are at increased risk for stones going forward. Prenatal vitamins are unlikely to cause stones, and are of critical importance to a healthy pregnancy.
With that many stones you should have a 24 hour urine collection to evaluate your urine chemistry while eating and drinking your regular diet. Only then can you know what aspects of your urinary chemistry are causing your stones. Your oxalates may be normal, but your calcium might be high, vice versa. Below is a link to a stone testing service that lists t...
This is always a possibility when ureteroscopy is done to eliminate stones. The tip of the stent rubs against the bladder, and can cause bladder pain or a feeling of always needing to urinate. The stent does widen the ureter to make a return look much easier to get the stones out.
Stones in the ureter, even if blocking on one side, do NOT cause swelling of the ankles etc. as long as you have a normal kidney on the other side. Certainly the pain your having could be from ureteral stones, and ureteroscopy is preferred in lower ureteral stones in child-bearing age women because lithotripsy may bruise the ovaries if used for lower uretera...
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