How to manage a stone in the ureter?
Q: Last month I had acute pain for three days localised to the right side of the back (L3 position). As advised by the doctors in urology, I took Anafortan for 3 days and there has been no pain as such till date. But as a precautionary measure, some tests (ultrasound, X-ray (KUB), IVP, blood urea & creatinine, urine culture, complete urine test etc.) were carried out and they detected a triangular stone (<1.0cm) in my right ureter. Now, I have got the following queries before going for any other option as follows: 1) What should be the best remedial action in such a case? 2) What is the significance of IVP and its detection of the stone in the urinary tract? 3) What is normally the confirmatory test for the detection of stones? 4) Is it mandatory to go for an immediate operation (like Laser Lithotripsy) for such type of ailments or is it curable by taking water 2-3 litres per day and specific drugs for the same? 4) Whom and which hospital (South Delhi / Delhi),would you suggest to consult for this? Please suggest how soon should I undergo the operation (if it is necessary at all) since all my reports related to blood and urine are well within the permissible limit? 5) Would you name some of the reputed hospitals /clinics, where Laser Lithotripsy can be carried out without any hesitation?
A:Stone in ureter needs to be taken out by lithotripsy or by ureteroscopy if it is not likely to come out within 3 weeks. It also depends upon hydronephrosis (dilatation of kidney). Depending upon location, lithotripsy is good for upper ureteric stone, with or without putting a stent. Ureteroscopy is good for lower stone. One has to examine the patient before predicting the passage of stone. IVP is a must before any procedure but not if one decides to wait and watch. There are many centres in Delhi like AIIMS, Gangaram hospital, RG stone, Apollo etc. where this can be done.