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No exit strategy for kidney stone

An IVP found that I have a three-legged kidney stone, 1.7cm each leg.  It is over a left upper pole calyx.  There is a filling defect around the kidney stone, but no significant obstruction was seen.  I am currently taking Bactrim daily to ward off further incidents of hemateria.  The urologist who treated me said that there was no exit strategy for this stone, that it's not going anyplace and punching a hole in my flank to remove it would result in the death of the kidney.  I have read about laser and laproscopic techniques to remove kidney stones.  In your opinion would these techniques would be a reasonable option for me, or should I accept the "no exit strategy" diagnosis and just learn to live with it?  I am 61 years old, have HBP and diabetes (latest A1c 5.7%).  Thank you.
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Avatar universal
MEDICAL PROFESSIONAL
Hi,

A stone that causes a filling defect and hematuria can cause kidney damage.
The wait-and-watch approach is usually used for small stones which can pass through the tract or do not cause any significant obstruction.

It appears that you have a struvite stone or one that resembles a staghorn structure.
These stones are more common in women and are usually the result of chronic infections.

The Bactrim you are on is an antibiotic and is to prevent infections, not further bleeding as the bleeding can be due to causes other than infection.

A HbA1C of 5.7 is indication that the diabetes is under control and this along with the blood pressure (if controlled) need not be reasons for ruling out surgical intervention.

The shape of the stone can cause concern with regard to the ESWL procedure, but there are other options such as percutaneous nephrolithotomy that can be considered for stone removal. You can state you would prefer active surgical management for removal of the stone when you meet your urologist, or get a second opinion from another urologist.

Do keep us posted on your doubts and progress.
Regards
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