AboutArthur Goldstein, M.D. Expertise Any problems or questions related to the field of urology; ie urinary stone disease, urinary cancers (kidney, bladder, prostate, testis, etc.), urinary infections, impotency, etc.
Experience I am retired from the active practice of urology. My 34 years was totally in the clinical field and involved the entire gamut of genitourinary problems, with special interest in male impotence and endourology.
Organizations American Medical Association, American Urological Association, American College of Surgeons
Question Hi,
I am really sorry to bother you but you are the only one that has talked to me so far. I got an answer to my referral from my Dr to the urologist he dos not wont to see me. The urologist talked to my Dr and I will see my Dr next week. Kaiser
I was diagnosed with celiac disease two years ago and quit drinking beer. I recently read that a study conducted in Finland suggests that the risk of developing stones decreases with beer. Maybe all those years of beer drinking were keeping those stones away and when I quite they started to form.
Recently there have been some beers marketed that I can drink.
Any thoughts on that?
Thank you
Ed
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Hi,
I got the results from the lab. It is a carbonate apatite stone. Does that mean anything to you?
I have not managed to get an apportionment with urology yet.
Thank you
Ed
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I started getting up at night three months ago every hour to urinate a week or two later I passed two small fleshy balls. Two months ago I passed my first kidney stone I am 57. I had a ct scan it showed no more stones a month later I passed another on the other side
I started Topamax for headaches just after this all started.
I can not convince my Dr to give me a referral to talk to a urologist.
I do not believe that Topamax could cause two stones in two months. I have only been taking Topamax for two and a half months.
I have had no explanation what the fleshy balls might have been. I have many on my frequent urination but nothing definite.
Should I storm the urology department?
Any ideas on the balls?
I really do not wont any more stones. They hurt!
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Ed, I was not familiar with the drug Topamax but the information on this medication states that those who take it have a slightly increased risk of developing kidney stones. I have no idea what the drug research states regarding how long it takes this process to occur. You might pose this question to the prescribing physician. It is probbly a moot point, however, as you state that your symptoms antedated taking the medication.
Urine formed by the kidneys passes down their respective tubes (ureters) into the urinary bladder. If a stone forms in a kidney and becomes looses it can then pass down the respective ureter. It typically, but not always, gives severe pain on that side. If the stone lodges in the lower ureter, it often irritates the bladder and gives the feeling of frequency which is what you experienced. Often with stones, the ureter may produce some blood and/or mucous in response to this irritation. The "fleshy balls" you passed probably well represent such an event. Another, although much less likely, possibility is a piece could break free from a a tumor of the ureter and present similar symptoms. If you still have the specimen (or pass any more) save it for a urologist to see. Although most stones show up on a CT scan, not all will. Sometimes other tests such as a plain Xray of the abdomen, ultrasound, IVP (intravenous pyelogram), etc. are needed. In spite of the negative CT scan, the fact that you still have frequency suggests either you have a residual low ureteral stone or something else going on. You should indeed see a urologist so that you problem can be defined more clearly and a course of management recommended. Good luck.
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Ed, the formation of kidney stones is a very complex process.
In addition, there are many different types of stones (such as calcium
oxalate, calcium phosphate, uric acid, calcium ammonium phosphate,
cystine, etc.). Carbonate apatite stones are formed from calcium, phosphate and carbonate. Each type of stone has many potential causes and multiple
metabolic factors are involved. Some stones can be stabilized or
prevented by dietary regimens but none are really dissolved by them.
Forcing fluids to ensure a urinary output of at least 2,000 cc (2 liters)
daily is an essential part of all stone prevention and treatment programs.
There is an incorrect belief that reducing calcium (such as dairy
products) in the diet prevents stones. This may help prevent some types
of stones but may predispose to others. A full metabolic evaluation is
necessary before a stone treatment program can be instituted. Therefore, it is appropriate to see a urologist. In people who have had more than 1 stone episode (as you have described), should have metabolic studies to try and find the underlying cause. In doing so, a proper preventative program can then be prescribed. Good luck.
Ed, metabolic studies are a series of tests to try and determine why a person forms stones. They usually include routine blood chemistries, a serum parathyroid hormone (PTH) level, and a 24 hour urinary assay for those constituents in the urine involved in stone formation. Other specialized studies that measure calcium absorption from the bowel and acid excretion by the kidneys are occasionally necessary as well. If the metabolic cause of the stone is found, a proper diet and medications can prevent recurrences in about 90% of patients.
Answer Ed, you need to be seen by a urologist. Having your faamily doctor get an informal opinion from him is not the same as the urologist doing a proper history, examination and personal review of your lab work and imaging studies. Anything less than this is not good medical practice in my opinion.
The more fluids you drink, the more urine you produce. Large volumes of urine dilute the waste substances that predispose to stones, thereby making it less likely they will precipitate out as stones or gravel. Certain items you drink such as beer, coffee and tea, in addition to being fluids also have a diuretic effect. This means that chemicals in these drinks cause the kidneys to produce even more urine than accounted for by just the volume of liquid alone. All stone formers should drink sufficient fluid to ensure a urinary output of at least 2 quarts daily. This generally requires drinking a minimum of 10 glasses (8oz) of liguid daily. This should become a life long habit. Although beer is liquid and has diruetic properties, it also contains purines (which can predispose to uric acid stones) and oxalates (which can predispose to oxalate stones). Although your stone analysis shows neither, you can see that stone formation and treatment can be complicated. Thus you need to see a good urologist!
