Urology/stones

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QUESTION: My daughter has kidney stones. The problem is that because of the pain being closer to the middle of her back and a few inches to the left, the Dr won't believe either her or me!

Anyway, I was reading up on the web about stones and I found a few articles that said the pain isn't ALWAYS predictable. Some people have pain in the morning and others at night and the location of pain can vary as well.

What I need from you is a third opinion. The Dr  wants o wait A MONTH and THEN re evaluate her. (Not if I can help it)

You're the 3rd opinion.  Does it ALWAYS follow the same pattern?

thanks,
joyce

ANSWER: Joyce:

You didn't indicate the age of your daughter.  In children, pain from a stone is frequently unpredictable and often abdominal.  Even in adults, stone pain can be in different locations.  A CT non contrast study is considered the gold standard for the diagnosis of kidney stones and this test or something similar may be necessary to clarify her diagnosis.

If she has or has had stones, you can also ask her physician about 24 hour urine testing for kidney stone prevention.

---------- FOLLOW-UP ----------

QUESTION: Hi. My daughter is 30. She is special needs. But she is not an idiot. You'd have to be pretty brilliant to not now your own pain.

Is a CT contrast study different than a regular CT? All she did was to like on a table and go through some machine. Then she had a KUB x-ray and they agree that she has stones.
Are they're any more tests that she needs done?

thanks,
joyce

Answer
Joyce:

CT scans are like x-rays.  You can use contrast or not or do both.  For kidney stones, a non-contrast CT is optimal.  We strongly recommend getting a KUB x-ray in addition when the CT is positive and it sounds like they did.

Further treatment depends on the size and location of the stones.  Usually, a urologist will be involved to determine optimal treatment.  Her pain may or may not be from the stones.  Kidney stones typically only cause pain when they are blocking or obstructing urinary flow so if there is no indication of obstruction there could be some other cause.

You can always get a second opinion from an outside urologist if you are not getting clear answers from her current physicians.  And she wouldb e a candidate for kidney stone preventino testing. Good luck.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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