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Urology/Kidney stone


I have been diagnosed with a 3mm kidney stone in the left distal ureter near the obturator internus muscle with mild focal hydroureter and no hydronephrosis. It has now been 12 days and I am on flomax, bactrim, and ibuprofen. Symptoms now are mild bladder pain with consistent urgency to urinate constantly. I no longer have flank pain. How long should I wait and observe before intervention such as ureteroscopy?  My urologist says he would like to let it try to pass on its own which could be days, weeks, or months. I would prefer to stay away from surgery.


First, your urologist can prescribe some oxybutynin to help reduce your urinary urgency.  It may also be possi9ble to increase your flomax to 2 daily which might help the stone pass a little easier.

In general, we recommend waiting 30 days or so for a small stone to pass before resorting to a surgery.  Waiting much longer tends to increase side effects and scarring.

A 3 mm stone should be small enough to pass: about 90% likelihood.  Stones 8 mm and larger are unlikely to pass on their own and often require surgery.

Also talk to your physician about 24 hour urine testing for kidney stone prevention.  If you are sufficiently dedicated and motivated to follow a long term plan for reducing your future stone risk, such an evaluation can help.


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Stephen W. Leslie, MD


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


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.

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

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.

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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