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Thread: Kidney Stone Removal Procedure

  1. #1

    Kidney Stone Removal Procedure

    Hi all,

    I am hoping that by writing this and get some answers or reassurance my anxiety levels may ease.

    In June my boyfriend had a kidney stone, he passed it. Then, about a week later he had another one. He was having significant pain and was having trouble peeing; therefore, they went in to try to remove it via Cystoscopy / ureteroscopy. and placed a stent at that time, too. They couldn't get to because his ureter was so swollen. So he still has this 6 mm stone in his kidney that is obviously causing some bleeding and his testicles have been swollen. We have been told this is due to the fact his body is trying to bear down to push the stone out and it will clear up once the stone is broken up. They will be reattempting surgery Thursday

    I am SO worried they won't be able to get it via Cystoscopy and ureteroscopy. and he will having to stay in the hospital a long time. I know this is mostly anxiety talking but why would they be able to get the stone now? Why would it be any less swollen? I know he's saying that it's because he passed a stone a week before they tried so it's had time to heal. My sister said if they didn't think they could get it this way, they would''t rebook and try again. But why would they be able to get up there now? I haven't been sleeping well and stuff. Just really struggling as I have separation anxiety. He is supposed to be having day surgery and home the same day.

  2. #2
    I am having surgery on Thursday as well to remove three stones that are stacked up in my ureter. I also have one large stone in my right kidney. I have a stent from my kidney to my bladder to keep it draining until the stones are removed. This is about the third time I’ve been through this. They should be able to go in there break it up and remove him and he should go on the same day.

  3. #3
    That makes sense. But if they tried to do it last time and everything was too swollen, why would they be able to get it now?

  4. #4
    Senior Member
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    Has Lithotripsy been tried (SWT) ? It is relatively non-invasive and worked well for me. It is an outpatient procedure.

  5. #5
    No, they won't do it because the stone is too low down? My question is what makes them think they;ll be successful this time if his urethra was too swollen to do the procedure last time?

  6. #6
    I have kidney and bladder ultrasounds twice per year. For some reason, my left kidney has a propensity to form stones. They have come and gone over the years, typically staying below 5 mm and are situated in a non-obstructing location and thus, I do not develop hydronephrosis. As of last month I have one that is 5 mm, having increased in size from 3 mm about a year and a half ago. My urologist is not concerned at this point since it is non-obstructing. However, it will definitely be easier to remove while it is smaller and once you start getting about this size, removal becomes a consideration.

    I do a 24 hour urine collection once per year at home and mail it in to Litholink, which produces an excellent report with all the pertinent elements of your urine chemistry. Each report also includes all of the previous reports, thus affording a good historical record. As a routine matter I tried to limit or eliminate all foods which have the basic stone forming chemicals. I would recommend you ask your physician for such a profile. One needs to do it on a day when you can be home, since all urine needs to be collected, something problematic at work or if outside for the day, unless one collects it in an unused liter bottle.

    I always wondered whether days or periods when I've had excessive spasticity it was due to a stone dropping into the ureter and working its way down to the bladder, which is when the pain occurs. Other than spasticity and dysreflexia, in the absence of visible blood in the urine it is very hard for those of us who are quads (and even paras) to know that this may be happening. I had a stone pre-SCI so I know how that felt. Even blood in the urine could be mistaken for UTI, cystitis, etc.

    In six months if it gets much bigger above 5 mm I probably will discuss whether it needs to be removed.

  7. #7
    I think they are going back in now believing that having the stent in place for several weeks will have relieved some of the irritation and inflammation and the urethra will be less swollen. The stone itself is an irritant, of course, but you said it’s within the kidney, and putting the stent in mechanically reduces the pressure against it and allows the lower urinary tract to recover and function sort of normally as well as heal up from the June stone.

    Stone removal (via lithotripsy or laser ureteroscopy) has always been an outpatient procedure for me (lithotripsy 4x, laser ureteroscopy 6x) and usually it’s pretty quick - less than 4 hours. If there’s also a UTI happening they generally won’t touch stones until there’s been a course of antibiotics to reduce the risk of sepsis. They usually won’t do lithotripsy if the stone is low because it almost inevitably leaves grit in the bladder which then sticks back together and makes more stones faster.

    Here is a thing to be aware of: getting the stone out of the kidney depends on where it is. If the stone is wedged in the lower pole, they may not be able to dislodge and remove it, and then you’re in a waiting game balancing his symptoms against leaving it in place and waiting for it to shift into a more accessible position. If his symptoms are intolerable or endangering other systems in his body, they can go in from the outside, which is almost always an outpatient procedure and also a last resort.

  8. #8
    They are going to zap it and it will break up into small particles and pass through the stent. They will then remove the stent after all the "gravel" has passed. He should be on antibioitcs before and at least a day or longer after.
    CWO
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

  9. #9
    Quote Originally Posted by SCI-Nurse View Post
    They are going to zap it and it will break up into small particles and pass through the stent. They will then remove the stent after all the "gravel" has passed. He should be on antibioitcs before and at least a day or longer after.
    CWO
    Thank you all for your responses, I guess what I'm not understanding is, if his urethra was too swollen to get to the stone last time, why would they get to it now? Is it because he hasn't passed a stone recently and he's been on anti inflammatories?

    He is on a course of antibiotics now.

    Thanks everyone!

  10. #10
    The stent is in the ureter, not the urethral. The urethral is from bladder through penis . Ureter(x2) is from bladder to each kidney. They have to fit the scope/zapper through ureter. Yes, on antibioitcs etc.. they will place a larger stent then crush it. Plus he probably had an infection so the antibiotics should reduce the infection and inflammation.

    CWO
    The SCI-Nurses are advanced practice nurses specializing in SCI/D care. They are available to answer questions, provide education, and make suggestions which you should always discuss with your physician/primary health care provider before implementing. Medical diagnosis is not provided, nor do the SCI-Nurses provide nursing or medical care through their responses on the CareCure forums.

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