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Question
So sorry to bother you again Doctor, but I have one more question.....i'm the 69 year old male who you've been kind enough to respond to the last couple of weeks......I was diagnosed with a kidney stone and at last X-ray was located just outside the bladder....Dr. didn't think it was a big deal and i should pass it....I have no pain anymore, just the constant uncomfortable feeling of continually having to urinate.....even if I haven't been drinking much......daytime I can handle it but it's difficult getting an night's sleep....and even if I get up, I usually can't urinate even though I try.....very uncomfortable.....I'm on flomax and he suggested saw palmetto as well.....again, no pain, just the uncomfortable feeling of constantly having to urinate.....sometimes I can pass urine and sometimes I cannot.....do you have any suggestions as to how to get past this feeling?   Really appreciate your time and expertise.

Answer
Don:

Saw palmetto has pretty much been proven not to do anything.  There are medications that can help reduce the urge to void, but they may have some side effects.  Talk to your physician about this.

A stone just outside the bladder that is 5 mm or less is almost certain to pass and even larger ones are usually given a chance to pass without surgery.  If this is not more than 3-4 weeks, it may be reasonable to consider a surgical procedure, either ureteroscopy or ESWL treatment, to get rid of it.

Meanwhile, try avoiding caffeine and take a hot sitz bath just before going to bed.  It helps the bladder relax.  May help a little.  

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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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