kidney stone question (Katie...?)

I've been very achy in my lower back and pelvis ever since passing the stone on Friday.  The CT last Monday showed multiple stones (I don't know exactly how many) in both kidneys, but they only found one in my urine in the ER on Friday and none showed up on the CT scan afterward... so at least one is unaccounted for.

This afternoon I started having some pain when I urinate and some discomfort when I wipe afterward. There is also a small amount of blood on the TP. Would this just be from the infection (I took the 3 days worth of Bactrim) or is it possible that I the "missing" stone is down low (I think Katie said she has one stuck just inside the bladder)?  Could a very tiny stone be down beyond the bladder but unable to get all the way out?  Would a stone show up on the CT if it was in the bladder?

I don't really know much about passing kidney stones... just wondering if I should just hang in there or if I need to go back in to see the doctor...

Lora

You may need lithotripsy to break the stone up.

The newest procedure done instead of the lithotripsy is a cystoscopy with a laser to blast the stones.  This way the stones dont' need to be passed.  I had this done 2 weeks ago due to one fairly large stone lodged in the ureter and another one up in the kidney.  They had to  put in a stent for 2 weeks that was taken out today.  I have to go back in 2 months to have more blasted from the other kidney.

The procedure you had was uteroscopic Holmium laser lithotripsy and that was the procedure I was suggesting to the OP.  

The lithotripsy process involves the use of either ultrasonic, electrohydraulic or shock wave methods to demolish kidney stones to smaller sizes, making them easier to pass through the urinary tract and excrete.

http://www.livestrong.com/article/35079-ureteroscopic-holmiu m-laser-lithotripsy-post/

Thanks for posting that link Sharyn.  I will definitely ask about it!

Lora

Hi, it usually depends on the size of the stone if it is less than 3-5 mm it passes by itself but u will have to drink lots of water to flu**** out but if it is larger it may have lodged near the urethra and might be the cause of the bleed on the tp. Infection is not going to cause it to bleed though bactrim has other side effects bleeding is not one of them as far as I know. If the pain intensifies or u still continue to bleed even small amounts I think u should see a doc or if the pain and discomfort stop u could focus on drinking plenty of fluids to flush the stones out. For larger stones u will need surgical intervention like lithotrypsy. Hope this helps

Also yes if there was a stone in the bladder it would show up on ct scan. When they say multiple stones in the kidney doesn't necessarily mean that all the stones r going to come out at the same time it is possible uncoiled have had only one stone traveling down when u had this pain so that is the stone which they found in the er. Trust me a tiny little stone can cause a whole lot of pain. If u r feeling similar type pf pain it is possible that u have a new stone traveling down. Like I said before dont wait too long if u feel an increase in pain or discomfort go to the er but if it subsides work on taking a lot of fluids to flush out the rest like I said before also depends on size of the stone.

wow i really feel for you! i pass kidney stones all the time, sometimes a couple a month. it sounds like you still have a kidney stone that is right there in your bladder and trying to come out. i don't think all kidney stones show up on ct because they said they broke the one huge one i had and there should only be small particles to come out but a couple of days later i passed a HUGE stone and i was like, how could they not see that on ct scan? just make sure you drink lots of water!

The bleeding may indicate that the stone is scraping the lining of the ureter or urethra depending on the size.  If you still have pain and haven't passed the stone, you need to see urologist and schedule procedure to treat the stone.  Additionally, you should be straining your urine.  The ER should have given you paper/mesh strainers.  The reusable ones can also be purchased at a surgical supply store for about $5.  This way you will be able to see if you pass the stone(s) AND be able to have it analyzed so you can prevent them in the future. 

I have had 8 kidney stones since RNY.  I have had one cystoscopy where they gave me an epidural, inserted a scope into my urethra and grabbed the stone and removed it.  Unfortunately they did not do pathology tests to determine the composition of the stone.  Since then I have had three lithotripsies where they blast the stone into peices with shock waves (AKA ExtraCorporeal Shock Wave Lithotripsy - ESWL).  They last stone was the size of a nickel and stuck in the renal pelvis of the left kidney causing fluid backup into the kidney and infection.  Despite two ESWL's it took 3 months to pass.  This stone was analyzed and found to contain calcium phosphate.  It turns out that many powdered drink mixes such as Crystal Light and Equate (Walmart brand) of Crystal Light contains Calcium Phosphate as an "anti-caking agent" which keeps the powder mix from caking in the packaging.  Examples include Crystal Light Fruit Punch and Equate's version of Crystal Lights Sunrise Orange flavor.  Interestingly enough the Crystal Light Decaf Iced Tea DOES NOT contain this agent.  My last stone was 2.5 years ago and I have been diligent about reading ingredient labels and have been consuming 3 liters a day of the Crystal Light Decaf Iced Tea and have had no kidney stones. 

I do get regular (6-12 month) X-Ray called a KUB (kidneys, ureter and bladder) to monitor for stones.  Because my stones aren't uric acid stones, medication will not help, so it really is a matter of drinking lots of the right fluids hence the 3 liters and watching the ingredients.  (Note: I would drink water, I love water, but since my RNY 7 years ago water causes severe nausea which I have found to be fairly common, so I consume the Decaf IT).

I have never had so much pain in my life as with my kidney stones.  I wish them on no one.  Please maintain your fluid intake to prevent future stones.  Also it is imperative to use Calcium Citrate over Calcium Carbonate as calcium carbonate isn't absorped well in RNY patients and also aids in causing stones when combined with lack of adequate fluid intake.

Best wishes and God Bless!!!

-Karen

agreeing with the others...
I also was given a strainer for my stones although I havent passed any of mine.  I have several as well.