Thanks Jim C. for your question.
You are correct about more aggressive action. The action I recommend is called prevention. Once you have had a metabolic work-up (blood and urine test) and a diagnosis of what is causing your stones, you should be treated diligently. Drinking excessive water can never hurt no matter what the cause for your stones.
As for the stone you have now in the left ureter, treatment depends on the size and location of the stone and the equipment available to your urologist. If the stone is less than 5 mm, you have a 95% chance of passing it on your own. This is especially true since you have passed other stones before. A watchful waiting approach has the least complication rate but needs to be tempered by realistic time considerations. You must remember to remain under doctor supervision until you pass the stone because chronic kidney obstruction can result in the loss of the kidney.
If the stone is larger / higher up in the ureter or in the kidney , ESWL (extracorporeal shock wave lithotripsy ) is usually the way to go but ureteroscopy ( using a fine telescope) with a laser or stone basket is a good second choice. If the stone is large or stuck in the lower ureter, ureteroscopy with stone basket, ultrasound, laser or other form of lithotripsy is usually recommended. A stent is used usually when ureteroscopy is employed to help avoid obstruction from ureteral edema and prevent problems from small holes in the ureter as well as allow for the passage of fragments from lithotripsy that might cause blockage when they pass.
Good luck with your visit to the urologist.
More individualized care is available at the Henry Ford Hospital and its suburban campuses by calling (1 800 653 6568). We can also arrange local accommodations through this number if this is your need. Please bring any physicians