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Unsuccessful ESWL

Appreciate comments on my case -

2 months back, had my first stone incident. Rushed to ER, where a CT scan was done. 3 stones were detected - one in ureter, and 2 in kidney. Doctor could not reach the stone so he ended up putting the stent and asked me to drink water (he predicted stones to be uric acid stones). Then I went for ultrasound every 10 days. 1st ultrasound said I have only 2 stones remaining. 2nd ultrasound said I had 1 stone of 6mm remaining. 3rd ultrasound said I had 1 stone of 8mm. Assuming ultrasound is not very accurate in getting the stone size - I assumed that it would be 7mm stone. All this while stent was inside my body. So basically, after 1 month of the incident, I had a 7mm stone left in my kidney, and stent was in in place.

Then I took some medication that supposedly breaks the stone (eastern medicine). I went for my KUB after 20 days of taking the medicine. KUB showed 3 stones with largest being 6mm. The other two were 5mm and 4mm. Now, I am confused as to what happened. Did the 7mm stone break, or ultrasound just did not detect the other 2 stones.

In any case, my doctor advised ESWL. We went for it in the hope that all the 3 buggers will be powdered in no time. Guess what, none of the stones could be crushed. The biggest one got 1500 shocks and could only be chipped a little. The other two were practically same size as before.

Now, my stent is removed, and I supposedly have 3 stones (2 months after the first episode). I passed some gravel (5-6 tiny pieces). After that nothing.  I am planning to give those pieces for analysis. Not sure what these stones are made of, that ESWL could not shatter.

My doctor is too relaxed about this (and practically unapproachable to talk in details) and hence I am posting my story here in hope that someone may have experienced similar thing and might share what to expect next.
2 Responses
1711789 tn?1361308007
MEDICAL PROFESSIONAL
Hi there!

There are a few types of stones that may be resistant to ESWL such as cystine or calcium oxalate monohydrate stones, where one may need to resort to alternative modes of treatment. Management in the given situation would depend on the position, size and characteristics of the stones and the clinical symptoms. It would be best to discuss the situation and the suggested further management plan in detail with your treating urologist.
Hope this is helpful.

Take care!
4851940 tn?1515694593
Sorry to hear of your problem, hope it is sorted out soon.
Great that you managed to catch some for analysis to determine which type of stones you have.

I had to have my kidney stone removed surgically because it was solidly stuck in the ureter.  But I had been very ill for months, each time parts of the stone broke and moved down and came through as very fine sand.  Mine were calcium stones and I was told to cut out all dairy food as well as certain veg and fruit.  Also to drink plenty of water (more than 4 pints per day).

As your doctor predicted that you have uric stones, it is because they did not break up when blasted.

Uric acid is a product of the metabolic breakdown of purine nucleotides. High blood concentrations of uric acid can lead to gout. The chemical is associated with other medical conditions including diabetes and the formation of ammonium acid urate kidney stones.

Listed below as some causes of high uric acid:-
In many instances, people have elevated uric acid levels for hereditary reasons.
Diet may be a factor. High intake of dietary purine as well as fructose (and table sugar which is roughly 50% fructose) can cause increased levels of uric acid.
Serum uric acid can be elevated due to reduced excretion by the kidneys.
Fasting or rapid weight loss can temporarily elevate uric acid levels

Hope the above info helps you understand a little more about kidney stones.  Hope you get the results of the composition of your stones soon so that you will know what foods to avoid in the future and an answer from your doctor about getting rid of them.  I found that I had no pain or problems with the urinary tract when they did not move.  But did experience pins and needles in my feet and noticed a puffy bag under one eye (the other side of the body from the stone) even before I knew I had a stone.  I was initially treated with a Vitamin B complex for the pins and needles and later with an antidepressant and after 6 months sent for Xrays that show the stone.  My doctor said that it was not their fault for misdiagnosing me because I did not have the typical text book symptoms of kidney stones!

All the best
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