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stone

Dr Rajesh Ahlawat
Chairman
Division of Urology and Renal Transplantation
Medanta Kidney and Urology Institute
Medanta, the Medicity

Q: Recently i got pain at lower stomach. The CT SCAN report is like this : KIDNEY(L):Normal size Normal echotexture. Cortico medullary differentiation well maintained. No calculi. Mild dilatation of pelvicalyceal system with dilation of ureter Till lower end which shows a calculus measuring 5mm at vesicoureteric junction Kidney(R): Normal size Normal echotexture. Corticomedullary differentition well maintained. No calculi. No hydronephrosis. -Both supra renal areas are free. -No paraortic lymphadenopathy. -No free fluid in abdomen. URINARY BLADDER : Moderately filled; BLADDER PROSTATE : Normal size, normal echotexture, no focal lesions IMPRESSION : (L)HYDRONEPHROSIS WITH HYDROURETER DUE TO VESICO URETERIC CALCULUS. Please notify me the status of stone. and precautions to pass it. Thanks in advance.

A:Chances of spontaneous passage are more than 90% for stones less than 5 mm at the lower end of ureter. Most of ureteric stones pass out during first 3 to 4 weeks after the first pain, meaning that chances of spontaneous passage go down substantially if it has not passed during earlier weeks. You may thus safely wait for its passage during this period. Medications usually prescribed during this period are NSAIDs and alpha blockers; these help keep you pain-free and improve the chances of passage of the stone. One should not wait for the passage if there is fever associated with pain as it means infection associated with obstruction. Usual advise of taking excess fluids has not been proved to be effective. In case of excessive pain, associated fever and non passage after couple of weeks after the first pain, it is advisable to have such a stone removed with help of ureteroscopy.