Sir i have 5 renal stones in kidney and 8mm stone in left vuj last

sir i have 5 renal stones in kidney and 8mm stone in left VUJ last night i have suffered from 7 hour of severe pain sir what i have to do please guide me



Hi ahmed, U have 3 problems at hand. 1) the lf vuj stone. Since u r in colic and the size of stone more than 5 mm with backpressure changes, I would personally advice URS. If you are hesitant to undergo the procedure, start on tamsulosin 0.4 mg hs and give a trial of a week, repeat usg of no improvement go for URS. Pain killers sos. Avoid excessive fluid intake during a colic. 2) renal stones. As their size is small try Conservative line of treatment with tamsulosin for 3 weeks and keep yourself checked with annual usg. 3) since u have b/l stone u need to undergo metabolic evaluation. In the long term good fluid intake to achieve an output of 2 lt and Syp pot citrate, low sodium and low protein diet with mod calcium will be helpful..

agree with dr jain

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8mm stones cannot expeled out with medical tt. u should go to renal experts and have ttment to free of all stones as per his guide-litho or other procedure to keep such obstructive pathology will definately damage your kidney!!

Dear have tendency of Renal calculi Plenty of water . Don't hesitate to urine or hold it. Investigation for UTI. TFT & TFT with electrolyte. LFT. Cystone 2 BD. liquid Alkasol qid with water. Doctors Brandy 30 ml + coffee. Tab Norfloxacin BD for 21 days. Tab Diclophenac + Dotavarine SOS .

drink 4-5 lit water per day.keep body hydrated.if u HV pain or burning micturation start antibiotic,painkiller and syp citralka..

Thanks for information.Drinking 4-5 liters of water a day thirsty or not,needed or not will have adverse effect on kidney because of overloading.We have seen cases admitted to urology wards and nephrology wards with kidney failure due to excessive intake of water.Please let me know the correct measure of water intake for a normal healthy individual

u shud give a trail of medical expulsion therapy..which is effective in lower ureteric includes steroid (defzalocort)/nsaid plus tamsulosin plus a diuretic (furosemide)....if it fails...then u can undergo URSL in which urteroscopically stone wud be retrieved.....for renal stone take adequate water and do serial usg...if stone fails to pass , go for eswl after doing ivp...

Good advice.But I oppose in diuretic therapy as it help attack of frequently colicky pain.Passable stone will be expelled out on its own ie in normal urinary stream n in physiological peristaltic wave.No need of plenty water intake nor diuretics.

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रोगी वृक्काश्मरी से पीड़ित है। चिकित्सा संबंधी योग,,,, पाषाणभेद मकोय पंचांग शाहतरा कासनी बीज पुनर्नवा गिलोय वरुण छाल गोखरु छोटा प्रत्येक 8 ग्राम लेकर काढ़ा बनाकर उसमें 2 ग्राम हजरलयहुद भस्म मिलाकर सुबह खाली पेट सेवन कराएं। निश्चित रूप से लाभ होगा। योग परिक्षित है। पिछले 40 वर्ष से प्रयोग कर रहा हूं।

Dear Dr Ahmed , you have bilateral lithiasis with left UVJ stone . I recommend left URS for the left UVJ stone . Rest of the stones would pass spontaneously but give a colic when they pass . In patients like pilots and marines I would have done a RIRS and retrieved all the stones . For future drink plenty of water and regular jogging helps . unfortunately recurrence cannot be avoided completely

thanks sir

Your pain is by the lower ureteric calculus. if you can tolerate the pain and irritating voiding then can wait for upto 4 weeks if there is no fever or severe unrelenting pain. can take an anti spasmodic analgesic and alpha blockers. if unable to tolerate go for a ureteroscopy which shall relieve you immediately. using the needloscopes will not require an indwelling stent. Regarding the bilateral calyceal calculi require expectant management to flush them out. if any of these calculi gets struck in ureter may require ureteroscopy. you also need to have your calculus analysis done and 24 hour urinary lithasis risk analysis to institute a preventive strategy to prevent recurrent stone formation.

agree with dr anil

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tab cital h two tab bd for 6 weeks repeat usg after 6 weeks .tab defcort 6 one tab bd for five days . tab taxim of one tab two times for five days .tab vellum 0.4 one tab at bed time for 15 days .tab hyocimax mf one tab three times sos . get your parathyroid hormone level

MET or medical expulsive therapy consists of 1.diuresis2.Antispasmodics and 3 Alpha adrenergic blockers. Diuresis is achieved by a minimum of 4 liters oral fluids per day and diuretics like lasix or torsemide 2.antispasmodics like anticholinergic drugs DONT work for renal colic .Only diclofenac is the best. to take at least 5omg thrice a day or 100mg retard once a day and finally 3.alpha blockers like tamsulocin or sildocin once a day. Since the stone on the left vuj has reached vuj ,chances are it might pass even .Hence the rationale of MET.. You will certainly metabolic assessment and diet control ona long-term basis. Also you need to save the stone passed for analysis.So carry a tea filter with you and whenever you pass urine pass the stream through the filter so that the stone is not lost.

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