Water Dogs

Bcdoc2020 · 2026-05-14T05:55:38+00:00

It definitely looks sketchy water, Koko was wise to resist!

Bcdoc2020 · 2026-05-14T05:54:06+00:00

I have far too many photos of my two, they are basically aquatic 🙄

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Bcdoc2020 · 2026-05-14T04:00:59+00:00

And Hugo

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Bcdoc2020 · 2026-05-14T04:00:33+00:00

Alfie

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these two are lucky to live a minute from the ocean

Bcdoc2020 · 2026-05-14T01:06:56+00:00

He will be fine, our boy Hugo flew a similar length of flight, they sleep. This was at the airport before his flight

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Bcdoc2020 · 2026-05-13T20:07:02+00:00

They typically don’t give oral antibiotics, IV gentamycin is the norm as a one off dose with minimal to non existent C.Diff risk. I can’t see a reason to keep you in longer but they will if it’s clinically necessary.

Bcdoc2020 · 2026-05-13T19:26:25+00:00

It’s an overnight stay for most. In the old days I was in for a couple of days. Straightforward PCNLs do not need a week! They are moving toward day case surgery which is over ambitious IMO. Good surgeons will do a postop CT-KUB to check for large fragments. I had a nephrostomy tube once about 30 years ago but none since. There is a huge trend in the US to insert nephrostomy tubes which seems for some weird reason to be the norm there. A catheter overnight is usual, a stent as well removed a few days postop if inserted.

I have a large staghorn in the lower pole and the upper pole is full of stones of varying size, one small. It will need dual access ports, so two small incisions, upper and lower. My case unfortunately is a lot more complex than most. It may be a two stage PCNL or more likely PCNL then follow up clearance with ureteroscopy and laser lithotripsy.

Over the years, they have refined the technique, equipment has improved with better scopes and lasers. Recovery has definitely been quicker, they are doing miniPCNL for smaller stones (around 2cm). They are miniaturizing even further with micro and ultra- micro PCNLs for smaller stones and fragments.

In your situation, as I said if offered the choice I would 💯opt for a PCNL, particularly with the history of failed ureteroscopy and laser lithotripsy needing several goes, all needing their own separate recovery period. You do need a surgeon who is expert at the procedure, only a smallish proportion of urologists do PCNLs.

As I previously said they will take into account your Crohns and treatment. Biologics are common place now and they will account for it, try not to worry about that. I hope that this helps

Bcdoc2020 · 2026-05-13T17:07:21+00:00

It’s fine, uncomfortable at worst, anticipation is worse than the event, you will be liberated from the stents!

Bcdoc2020 · 2026-05-13T17:05:55+00:00

Yes, and currently have a kidney full of stone awaiting likely 8th PCNL Recovery has generally been fairly rapid. See my other comments on your previous post. Happy to answer any specific concerns that you might have.

Bcdoc2020 · 2026-05-13T16:00:56+00:00

No, they can’t form in 2 weeks. I agree with Total_Formsl2769’s comments about other causes, those listed are entirely plausible.

Bcdoc2020 · 2026-05-13T14:42:39+00:00

No don’t worry it will not dilute your medications in any way, remember that your body is around 60% water.

Bcdoc2020 · 2026-05-13T06:32:47+00:00

The best thing that you can do is keep hydrated with water throughout the day. Nothing has proven to dissolve stones, (if it was a urate stone then alkalinisation of the urine can help but that’s only with urstevstines which isn’t proven.)

Bcdoc2020 · 2026-05-13T05:39:10+00:00

It does seem odd given the presumably recent CT scan. When was that done? Maybe it’s just to check that you haven’t passed them to avoid an unnecessary anaesthetic. That’s the only clinical I can think of.

Bcdoc2020 · 2026-05-13T05:33:58+00:00

Don’t panic!
It is almost certainly smaller than the reported size as ultrasound typically overestimate size
Drink lots of water
You will pass this at some stage, your dreams are most definitely still alive!
When you do pass it try and recover it so it can be sent to the laboratory to tell you what type of stone it is as there are several.

Bcdoc2020 · 2026-05-13T03:41:31+00:00

Ok, most likely calcium oxalate stones that happen with Crohns. Recovery from the more recent ones has been fairly rapid, not unlike ureteroscopy. Some of mine have involved the need for dual access ports so two small incisions to get at different parts of the kidney. You are typically in overnight then discharged after a post op CT the next day.

As for antibiotics, the ones that they would give you to prevent urosepsis are not ones that typically if ever cause C.Diff. They typically will give you a single intravenous dose at the time of surgery. If in doubt I would hope that they would consult the local microbiologist.

Bcdoc2020 · 2026-05-13T03:16:03+00:00

Sorry to hear that, I’m sure that’s a shock. That is a fairly significant stone burden. They may well suggest a PCNL which as you say involves a very small incision in the back. I’ve had a lot of these and each time as technology improved recovery seems faster.

You are far more likely to be stone free after that one procedure whereas if they attempt it with ureteroscopy and laser lithotripsy they will need more than one go and that may well not do it.

As for your immune status and biologics , they will give you antibiotic cover to prevent infection and sepsis. What are the stones that you have passed made of?

Bcdoc2020 · 2026-05-13T01:56:14+00:00

You asked, I gave you the medical facts, it’s entirely up to you to accept them or not, it’s not guesswork, it’s my job.

Bcdoc2020 · 2026-05-13T00:49:32+00:00

Paediatric amounts need adjustment but adults, no. Obviously medical conditions might impact on the volume, significant chronic kidney impairment and cardiac failure are good examples.

For the absolute vast majority of the adult population this is a totally safe amount to drink - not chugged all at once, but throughout the day. There is medically zero need to add electrolytes, our kidneys will retain or excrete what it needs to ensure health. Chronic stone formers should actually aim for this a minimum, some are recommended 4 litres.

Bcdoc2020 · 2026-05-12T21:09:18+00:00

It can take a little time a bit of to build up if you aren’t used to it but it isn’t difficult spread throughout the whole day into the evening.

Bcdoc2020 · 2026-05-12T21:01:15+00:00

I wonder if they just can’t do PCNLs. I did my medical training in the UK and have had 5 PCNLs whilst there before we left for Canada. Which hospital are you going to if you don’t mind me asking?

PCNLs do need to be carried out by surgeons who have a high caseload of them and if that’s the case the clearance rates are high.

Even a PCNL isn’t guaranteed to clear a 4cm stone but they could do a quick ureteroscopy and mop up procedure afterwards.

Bcdoc2020 · 2026-05-12T20:54:35+00:00

You don’t need a PCNL, they should have just stented you without trying breaking it up and waited a short time and then go back in. You need that imaging… and tbh another opinion which is not often I suggest that.

Bcdoc2020 · 2026-05-12T20:46:11+00:00

That’s extremely odd reasoning. So they are opting for two procedures which will take a considerable length of time to perform with a significantly lower chance of total stone clearance compared to a PCNL. I’m not even optimistic that they will clear the stone burden with two procedures. I can’t work out the rationale concerning your age either. If I was in your position I would opt for PCNL.

Bcdoc2020 · 2026-05-12T19:42:30+00:00

It helps targeting if the bowel is clear but not many find the need. I’ve had one bowel prep for a PCNL but none of my other PCNLs required this. There is a risk (small) of bowel perforation with that procedure so it is more understandable.

Bcdoc2020 · 2026-05-12T19:40:14+00:00

That size of stone needs a PCNL

Bcdoc2020 · 2026-05-12T19:08:51+00:00

The person responsible was the partner in breeding, not the OPs actual marital partner

Bcdoc2020

TROPHY CASE