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Question
Went to ER a month ago with a stone found on CT scan. Pain at that time was intense and in the lower left abdomen. Since first day pain has been decreasing. CT scan a month ago showed it was about to drop into the bladder. I am seeing a urologist, wants me to do an IVP next week. (I hate IVs.)The pain/burning now is mild and is only felt during the last two seconds of urination, somehere in the urinary tract, not in the penis or any place low like that. Is that any help or indication where the stone might be?

Answer
Alex:

Since the stone was "about to drop into the bladder", it is most likely still in the same place.  This can cause some bladder irritation.  Once in the bladder, most stones have no immediate symptoms.

We rarely use IVP's anymore even though it's a good way to see exactly what is going on.  Usually, we do a plain x-ray called a KUB at the time of the CT scan.  If we can see the stone at that time, then we can easily follow it later just by repeating the KUB x-ray.

You can ask your urologist about avoiding the IVP and just doing a plan x-ray and maybe an ultrasound.  This may be sufficient to determine what is happening.

In general, smaller stones (4 mm and smaller) have a 90% chance of passing while stones 8 mm or larger are unlikely to pass without surgery.

Also ask your urologist about kidney stone prevention testing, if you are interested.  This usually requires a 24 hour urine test to look into the chemistry.  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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