Q: I am a 27 years old male with kidney stones. When I first got my ultrasound done, the report stated a stone measuring 4.3 mm in the right kidney and mild hydronephrosis and hydroureter with 4.7 mm calculus in the right vesico-ureteric junction. The left kidney had a stone measuring 5.5 mm and calculus had been found in lower calyx. My latest ultrasound reports mild hydronephrosis and hydroureter in the right kidney and a 5.8 mm calculus in lower calyx of left kidney. I have pain in my right kidney. While browsing the Internet, I came to know that it might be because of mild hydronephrosis and hydroureter. What is it and how harmful can it be? I occasionally have beer and also smoke 2-4 cigarettes daily. Can this worsen my situation? What mode of treatment should I undertake?

A:Hydronephrosis and hydroureter means dilation (distension) of part of urinary tract called renal pelvis and the ureter respectively resulting from an obstruction of the tract by the stone in your case. Persistent hydronephrosis especially accompanied with pain would require a close follow up with your Urologist. If neglected, it could impair the kidney function on the affected side. Kidney stones of under 5 mm size most often tend to pass spontaneously. However, if the stone persists to cause an obstruction along with the symptoms of pain, then it would require a surgical intervention by a Urologist for its removal. Since you have multiple kidney stones with increased chances of recurrence, you would need a chemical analysis of the passed stone if possible and a 24-hour urine studies for quantitification of various minerals like calcium and oxalate. Abnormal excretion of these minerals would help us to find the cause of kidney stone and accordingly help in the medical management. Also, drinking at least 1.5 litres of liquid daily along with being on low salt diet would prevent chances of recurrent stone formation though it would not be able to dissolve an already formed stone as in your case.