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Kidney Stones, a patient’s perspective pt 2

Kidney Stones, a patient’s perspective pt 2

Kidney Stones in 1986

Having experienced kidney stones twice in the past 30 years (see A Kidney Stone, a patient’s perspective) has given me some good insights, which I share with our patients at the New York offices from time to time.  There are many aspects involved with diagnosis and treatment of kidney stones. Fortunately, our diagnostic and treatment options have improved significantly. Over time the art and science in treating kidney stones has improved vastly.  I say art since not all stones are treated in the same way.

When I suffered my first kidney stone attack in 1984 diagnostic and treatment options were limited.  During that episode the pain was unforgettable.  It was like nothing I had ever experienced. At the time the mainstay of pain management consisted of narcotics which carry significant side effects.  Patients where prescribed Percocet and/or  morphine which did dull the pain caused by kidney stones but carried side effects of nausea, dizziness and constipation.  The diagnostic options at the time of my first attack consisted of plain x-ray and intravenous pyelography (IVP). IVPs are rarely done today. This type of x ray was time consuming and and required an injection of dye into the bloodstream to locate the stone.  X-rays do however deliver significant radiation exposure.

In 1984, I was unable to pass my stone (3-4mm) which was located in my left ureter (tube which transports urine from the kidney to the bladder) and caused intense and constant pain.  There was no form of medical therapy at that time. My treatment consisted of a surgical procedure called ureteroscopy and stone extraction. At that time the instruments were large and cumbersome.  During this procedure, the doctor inserts the ureteroscope through the urethra, into the bladder and then into the affected ureter.  There he uses the instrument to visualize and grasp the stone to remove it.  In some cases, the doctor has to break the stone into smaller fragments and remove them one at a time.  The smallest pieces are to pass normally during urination.  I underwent this procedure which lasted 2-3 hours and I was kept in the hospital for 3 days. The pain from the procedure was severe.  After the procedure an ureteral stent was inserted to keep the ureter open and allow urine to flow from the kidney into the bladder.  The ureteral stent was kept in place for one week.  It left me with significant sympthoms.  After it was removed, I slowly returned to my normal day to day activities.

In hindsight, the progress we have made over the last 30 years in treating kidney stones is amazing .  Im glad we at New York Urological in Manhattan have access to much advanced methods for treatment today.   I’ll be discussing my most recent experience in my next post for comparison of all aspects; from diagnosis through treatment.  We know how it feels and understand that prompt and efficient treatment are the key to a better experience.