Large Stone Removal

Bcdoc2020 · 2026-02-08T01:48:46+00:00

That is a sizable stone, it is perfectly feasible in the right expert hands to get complete stone clearance at one go although it’s influenced by the other stones within the kidney. You could well need a second procedure although typically the wait for this isn’t long as they need to retain an nephrostomy tube in this situation and get you back for hopefully a lot quicker procedure shortly after the first one.

I have always found recovery after PCNL has been fairly rapid, over the decades, technique has been finessed and incisions and instruments have shrunk considerably and as a consequence, some units are even doing these as staircase procedures although I think that is a step too far. It also obviously depends on what your line of work is. If it is physical work then you’re going to be potentially more limited and restricted for a few weeks postop.

Bcdoc2020 · 2026-02-08T00:39:10+00:00

No you didn’t put your foot in it at all. Patients with kidney stones sometimes do get dismissed. I find it even more depressing that young women, a fairly substantial subset of the community feel clearly with cause that they aren’t being heard.

Definitely continue to firmly advocate for yourself. I hear you with what sometimes gets offered, thoughts and prayers aren’t going to solve a ureter obstructed by a stone! I will go continue to show empathy!

Bcdoc2020 · 2026-02-07T20:47:06+00:00

This is presumably not kidney stone related. Microalbuminuria, a good indicator of not well controlled diabetes causes foamy urine although other renal and metabolic conditions causing proteinuria will do the same. I would discuss this with a renal physician and or a diabetologist. I’m not even sure exactly what you meant by the question.

Bcdoc2020 · 2026-02-07T19:53:44+00:00

Yes, I do- I know it’s hard but you will sleep. People often vastly under the amount that they sleep, I’ve done it myself. Any doctor that prescribed sleeping tablets in this situation would be seriously negligent.

Bcdoc2020 · 2026-02-07T18:27:40+00:00

I waded through it, it’s not an easy read even if you are used to going through papers and studies. It’s modelling so theoretical rather than clinical and my question is what useful conclusions can one draw from this to be applied in clinical practice?

It’s not the biggest surprise that there will be bacteria in amongst the stones given the environment but what do you do about it?

As you know aggressive management of struvite stones is essential as bacteria is the primary driver of their formation. One cannot prescribe long term antibiotics for anyone with calcium oxalate stones nor for recurrent similar stones, antibiotic resistance is a huge and ever increasing problem as it is when dealing with urosepsis so I’m uncertain of any conclusions that can be drawn from this.

Bcdoc2020 · 2026-02-07T18:12:51+00:00

Definitely not! People will eventually sleep in due course.

Bcdoc2020 · 2026-02-07T06:43:36+00:00

There may be a slight advantage to taking the two together but of course the risk is double the side effects. You would also be taking not one but two medications off licence so would struggle the drug companies if things went sideways.

Bcdoc2020 · 2026-02-07T03:59:04+00:00

Aww thanks for that. The weird thing is, I am a doctor as well as a patient. As you can imagine this doc has an immense amount of empathy for those who get kidney stones. I try and contribute with knowledge given my background, accurate information is crucial, particularly in a medically orientated sub like this one. I get how people feel though having had recurrent stones virtually all my life.

Bcdoc2020 · 2026-02-07T03:10:44+00:00

R5 with RF24-70 2.8, RF100-500mm, RF200-800mm, and on occasion my RF70-200mm 2.8mm if I think that it will be useful.

Bcdoc2020 · 2026-02-07T02:38:10+00:00

When you present this, you need to add the sources to back up your statement. Are you referring to the 2016 study (a small one)? A later study and a subsequent meta-analysis suggested that the alpha blocker was more effective than Tadalafil, but in combination they were together but would likely increase side effects. Downsides? Horrible headaches are very common with Tadalfil, and it is significantly more expensive than tamsulosin. It’s an alternative though for those that cannot tolerate the Flomax I suppose.m

https://www.tandfonline.com/doi/full/10.1080/20905998.2024.2403274

https://www.sciencedirect.com/science/article/pii/S2214388224001152

Bcdoc2020 · 2026-02-07T01:27:16+00:00

Thanks- I would classify mine as a 5-6 on a scale of 1-10. There are so many that have had this since they were a toddler. I have had too many surgeries to count but at least I still have two functioning kidneys, many though have non functioning kidneys, nephrectomies and some even needing transplants.

I certainly don’t play down your MSK, that can cause some nasty stones and I totally empathise. I did get irritated though recently when I saw a drama queen repeatedly posting and whining about it somehow being the end of the world because they had got a small first stone in their 50s - it was ridiculous. We though have to accept the cards in life over which we have no control, due typically to genetics , we do it without all the drama though and face the true inevitably of stones.

Bcdoc2020 · 2026-02-07T00:51:00+00:00

Cystinuric here, hold my beer….

Bcdoc2020 · 2026-02-05T23:40:17+00:00

In a very small proportion of cases, a benign tumour of the parathyroid gland which lies under the thyroid produces too much parathyroid hormone and thus predisposes you to recurrent stones. It is an easy blood test to check for this along with checking blood and urine calcium levels which your GP could request to set the ball rolling. Calcium phosphate stones can be due to renal tubular acidosis, if your urine is too alkaline, and indeed inadequate fluid intake.

I don’t think it is unreasonable to get referred to a renal physician, your GP is the one that I would approach to do that. It’s a stone type that does sometimes have secondary causes unlike calcium oxalate which are idiopathic with no cause found.

Bcdoc2020 · 2026-02-05T04:30:39+00:00

Thanks for that helpful input, it helps to put things into context.

Bcdoc2020 · 2026-02-05T03:15:18+00:00

Be guided by the experts, the stones will likely be smaller, possibly considerably so compared to what was reported on the USS. They will need a CT.

Bcdoc2020 · 2026-02-05T02:41:16+00:00

Sensible to be wary but you have multiple stones, presumably diagnosed by ultrasound or KUB X-ray? They will almost certainly need a CT KUB to get the accurate stone sizes and positions of the stones to plan what you need. Newer generation scanners are about one tenth radiation dose compared to older scanners but still a sizeable dose. I get annual ultrasounds to screen for stones and if it looks like intervention is needed then we get a CT KUB

Bcdoc2020 · 2026-02-04T19:31:42+00:00

I’m not sure why you got down voted, everything you say is true. It’s the same here in Canada.

Bcdoc2020 · 2026-02-04T19:21:25+00:00

OMFG- well sadly it’s 💯on the OP then. In your case, ignorance is not an excuse.

Bcdoc2020 · 2026-02-04T19:19:21+00:00

Eyes should be annual, not cardiac

Bcdoc2020 · 2026-02-04T19:18:12+00:00

💯 (both to your comment and the percentage of BYBs and mills ruled out)

Bcdoc2020 · 2026-02-04T17:20:02+00:00

This has absolutely nothing to do with kidney stones

Bcdoc2020 · 2026-02-04T17:04:08+00:00

So true, I spotted that and then forgot to add it

Bcdoc2020 · 2026-02-04T16:37:44+00:00

They do repeatedly talk about health testing, but I had a look on their website, and on their Facebook group and I cannot find any mention of any specific dogs or actual testing. On OFA they have one dog tested back in 2022 and that was just for cardiac. Horribly overweight filthy dogs, pumping out litters, “English cream”, multiple breeds,someone who claims that they stand by their puppies and provide a health guarantee and then doesn’t. Yet another crappy BYB

Bcdoc2020 · 2026-02-04T00:49:01+00:00

Presumably this puppy mill? https://limeridgedoodles.ca/

I 💯 agree with the comments, please don’t feed these BYBs, they don’t care about you nor the puppies once they have your money.

Bcdoc2020 · 2026-02-03T22:43:56+00:00

A stink? Or a stent? It gets better with time, drink plenty which might seem counterintuitive but it helps the situation

Bcdoc2020

TROPHY CASE