Q: I am a 30 years old married man who suffered from left abdominal and back pain two days back. I thought it might be due to gastric trouble or indigestion. I was suggested to take Cataspa and Pepfiz, which gave me relief for a day only. But next day, the pain again started and it was more severe than before. Ultrasound examination of kidneys and urinary bladder (USG of KUB) was done and the report states: Impression: 8 mm stone in left upper ureter with mild back-pressure changes. Bilateral renal stone. What treatment should I undergo? Do I need to undergo surgery? Is there any surgery, which can relieve me from this pain and stone? Is it necessary to remove the stones?

A:You have bilateral kidney stones with left sided stones causing symptoms of pain arising from obstruction of the outflow urinary tract. Most stones which are asymptommatic, like not causing pain or repeated urine infections are best left unattended with close monitering of symptoms. Based on the information, it seems you would need an evaluation by a Urologist with possible surgical removal, if the symptoms of pain resulting from obstructing stone on the left side persist. Before undertaking a surgical intervention, you are advised to drink atleast 2 liters of fluid on a daily basis intended to help in the spontaneous passage of the formed stone. Unfortunately, most stones of sizes > 5mm doesn't spontaneously pass and if continue to cause symptoms would need surgery. Urologist would help decide the type of surgery based on the location of the stone. Lastly, you would need 24 hour urine studies for quantification of various mineral/salts and also if possible chemical analysis of the passed/removed stone. This would help to know the type of stone and accordingly guide the specific medical therapy which does help to prevent future stone formation.