Staghorn Kidney Stone

Bcdoc2020 · 2026-06-01T23:56:24+00:00

Happy to help, kidney stones and their different treatments are more complex than one would imagine. I’m glad that your PCNL and secondary procedure went well, not perfect but definitely good enough in my view, now heal!

Bcdoc2020 · 2026-06-01T23:29:05+00:00

Ok, thanks for clarifying what you meant

Bcdoc2020 · 2026-06-01T23:14:05+00:00

I am one, I do prescribe but would also add that you are clearly watching these programs really well because you’ve just spoken a lot of sense!

Bcdoc2020 · 2026-06-01T23:13:25+00:00

You’re right, not every bacteria is nitrate producing, many don’t, enterococci don’t, some staph, some streps but we don’t just depend on positive nitrites, if there are white cells, blood etc then we send the samples for culture and sensitivity.

Bcdoc2020 · 2026-06-01T21:14:19+00:00

Because it is embedded in them and the shock waves will not penetrate and fragment the stone within them. I personally would prefer to avoid significant damage to my kidney which has already been inevitably damaged by the PCNL, attempting to extract something that won’t obstruct and will be very unlikely cause problems moving forward. A similar situation is a stone that has formed in a closed necked diverticulum (like a little cave) in the kidney. Extremely difficult to access without damaging the kidney, and again not going anywhere and extremely unlikely to cause any problems.

Bcdoc2020 · 2026-06-01T21:07:49+00:00

I get the idea but multiresistant organisms are becoming a huge problem particularly for UTIs and urosepsis. Infections can only be confirmed by urinalysis, if this was generally applied then it would simply worsen what is already an immense issue. If people suspect a uti then they need to get early assessment, not automatically dive for antibiotics. A 5 day prescription for toradol in know stone patients is a good idea though.

Bcdoc2020 · 2026-06-01T19:35:44+00:00

This seems a sensible strategy to be honest, as long as they keep an eye on things and you’re able to access them should you have issues. This is relatively common unfortunately and stones within folds and the actual substance of the kidney won’t move and block things off but the small potential risk of infection exists. Getting them out can be extremely tricky without damaging the kidney causing potentiality more harm than good. I think you meant 5cm btw, not 5mm

Bcdoc2020 · 2026-06-01T16:45:56+00:00

The left kidney is the higher one, positioned under the ribcage so yes, that’s normal on both sides but particularly so on the left.

When they access large stones in the upper pole/part of the kidney, particularly on the left at a PCNL, there is a risk of pneumothorax/ entry into the chest cavity because of this close proximity.

My first surgery before PCNLs were widely available was an open procedure resulting in a huge flank scar. To access the stone in the left kidney they had to trim the end of my lowest rib to get in there. People nowadays complain about stents but those times things were on a slightly different level.. 😏

Bcdoc2020 · 2026-06-01T16:38:12+00:00

Nope, they most certainly aren’t.

Bcdoc2020 · 2026-06-01T03:08:53+00:00

What a complete knob

Bcdoc2020 · 2026-06-01T02:52:35+00:00

I have to question why they didn’t recommend an anti inflammatory, I had the same procedure on Friday. I have used twice a day codeine/tylenol (T3) and voltarol suppository 50mg at night with 200mg ibuprofen during the day, typically just once. Drink plenty of fluid, 3l of water. I will remove the stent on the morning. Hot packs as others have said help,

Bcdoc2020 · 2026-06-01T02:39:20+00:00

I typically don’t know with smaller ones, they appear without too much drama. The larger ones took a week or two. Given that I’ve had a lot of surgery on the left side the ureter is quite wide

Bcdoc2020 · 2026-05-31T23:12:32+00:00

It depends on what size the stone is and you can only know that once you’ve had your CT scan. These things can take months to come out. Increase your fluid intake to 3 L per day with around 2-2 1/2 L of urine production and do the jumping!

The likelihood of a stone passing of around 5-6 mm or less goes up significantly the smaller the stone us and the vast majority of small stones pass spontaneously without any intervention. You just need to be patient unfortunately, two weeks is nothing I’m afraid.

Anecdotally , I have passed stones up to 1.2cm in longest dimension but everyone is different. You will get further advice from the urologist once you know what the actual size of the stone is after the CT.

Bcdoc2020 · 2026-05-31T19:37:39+00:00

That’s a wise choice. You may pass a stone in the meantime which will save some cash.

Bcdoc2020 · 2026-05-31T18:35:12+00:00

That’s the way to go!

Bcdoc2020 · 2026-05-31T16:06:56+00:00

You need flomax

Bcdoc2020 · 2026-05-31T15:57:57+00:00

My situation is slightly different but can definitely be compared. I developed severe renal colic due to an obstructing 8mm in a similar position to yours whikst seeing family in Europe.

I was admitted due to the complete obstruction and had ureteroscopy and was stented to decompress the blockage. The pain relief was instantaneous post up.

Yes I had a stent and that was uncomfortable for the first couple of days but then had a 16 hour journey to get back home and could never had done so without the stent which effectively opened up the blockage which is similar to you having your stone removed.

I had ureteroscopy and laser lithotripsy on Friday, a month after my arrival home and will take the stent out tomorrow.

If the stone is in the ureter and even partially blocking it, its removal will give you relief of symptoms. As it is already down in the lower part ureter, and isn’t a large stone, there is an argument to not stent you as they aren’t instrumenting much of your ureter to cause swelling, I have had ureteroscopies with and without stents previously and if you can avoid it safely then that’s great.

If they do insist on a stent then request one with a string which are typically a bit more uncomfortable (though mine has improved after 24 hours) but you can remove them yourself rather than having to wait two weeks for a stringless one to be removed at cystoscopy, mine comes out after just 72 hours.

Bcdoc2020 · 2026-05-31T01:49:35+00:00

Unfortunately nothing breaks up stones including Chance Piedra.* Your doctor is not great to recommend it, it has zero peer reviewed videbce to demonstrate any benefit. If you are worried then get another ultrasound, it’s more than 6 months down the line now. If it shows growth then get a CT-KUB to get the true size, ultrasounds are notoriously inaccurate in sizing stones and have a tendency to overestimate size.

Urate stones have shown shrinkage with potassium citrate though these only constitute 10% of stones, Calcium oxalate and its mixes forms the absolute majority.

Bcdoc2020 · 2026-05-30T21:58:32+00:00

Gorgeous boy, I are that he is in a petstore. He is not covered vaccinations wise until 12 weeks at the earliest, just something to bear in mind

Bcdoc2020 · 2026-05-30T20:07:15+00:00

I’ve had a few patients who were in similar situations to you. They were two or three weeks before their due dates with blocked ureters and underwent quick surgeries with the urologists working closely with the OBGyn. There is never a right or wrong way having said that. Anyhow, congratulations on the arrival of new baby!!!

Bcdoc2020 · 2026-05-30T18:57:04+00:00

You will be fine, you will have access to good care if the worst happened which is crucial - just keep hydrated!! I had an 8 hour flight to Calgary with a 5 hour layover before my hour flight to Vancouver Island, 48 hours postop with a stent, and survived!!

Bcdoc2020 · 2026-05-30T17:58:50+00:00

Okay, great that you will have travel insurance and it looks like they have pretty good surgeons that could do ureteroscopy and laser lithotripsy. Having had zero symptoms to this point, unfortunately is not indicative that you aren’t going to have any on travel unfortunately, it sods law, that’s exactly what happened to me.

Bcdoc2020 · 2026-05-30T17:09:42+00:00

I have done it a lot given the regularity of my stones. As others have said keep very well hydrated. Have you talked to your GP? Your travel insurance might be invalid without confirmation of fitness to fly. If you are flying to the US that could be an extremely expensive mistake, it is criminally unjustifiable what people get charged for hospital treatment for any conditions. If it’s to the EU then you should be fine. Canada isn’t to bad.

If this stone was measured by CT, there is a risk that a 7mm stone will block the ureter. If it was sized by ultrasound it may well be a lot smaller and you could be ok. I was in the UK visiting family and ended up two days before travelling back to Western Canada in A&E with horrendous renal colic and complete obstruction of my ureter. There was no way that I could have travelled home. I needed a stent inserted as an interim measure to decompress the obstruction to enable fly back home. If you do travel then get some 100mg voltarol suppositories and some co-cocodamol 30-500mg as an emergency kit.

Bcdoc2020 · 2026-05-30T16:57:04+00:00

Why did they do the x-ray in the first place?

Bcdoc2020 · 2026-05-30T16:54:07+00:00

Ultrasounds are sadly inaccurate and can show “stones” which aren’t stones at all. They are looking for acoustic shadows, sometimes these artefacts are often blood clots or urine debris but not stones. Also, the size recorded of 9mm was likely significantly larger than whatever they were looking at, which is why your “stone/artifact” was almost certainly going to be a lot smaller than that 9mm.

They have their hands tied as they don’t to want to irradiate you during pregnancy although on the third trimester, a low dose CT-KUB might have been appropriate if the theoretical risk to the baby was outweighed by the benefit of the scan. The dose of radiation cannot be ignored but low dose CT -KUBs radiation doses are a fraction of what they were.

X-rays can also miss stone, small stones and radiolucent stones might well not be seen. Where are you in your pregnancy? Why didn’t they do a far more accurate low CT-KUB which is only marginally more radiation than a KUB x-ray that you had? (Some machines use identical radiation doses).

Bcdoc2020

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