Need personal experiences!?

Question

I am 16 years old and i am set to have lithotripsy for kidney stones early in september. I have had lithotripsy before and found it rather painful, i did not have an anesthetic and was not offered one. I was given a painkiller which didn't seem to have any affect, i would like to know about other peoples experiences and if you found it painful as well. i would also like to know if i could request to have something stronger for the pain, if so what do you think they will give me as an alternative?

My doctor has informed me that my stone is 1.5 cm and is high up in my kidney, for this reason he has ruled out PCNL as the stone is too near my spleen and would be a major operation instead of a minor if it was to be done.

He has told me that if lithotripsy does not work again this time i am going to get ureteroscopy, i would also like to hear peoples experiences with this as i only know basic details about the procedure. i am also wondering if the procedure can be done if i have an IUD (coil) in place or will it need to be removed before the procedure takes place?

Answer 1

Basically what happens with a ureteroscopy is they take a scope, pass it up through your bladder, through the ureters to the kidney. They can pass various tools with that scope, including a laser and a basket to capture fragments. They take the laser, touch the stone, break the stone up, then capture the fragments, clearing the kidney. There's debate in the medical community about stents after an "uncomplicated ureteroscopy". However, most likelihood, to prevent what are called "strictures" (scar tissue narrowing the ureter), or blockages, they will put a stent in. It's kept in at LEAST for 3 to 5 days.

The advantage of ureteroscopy over lithotripsy is that you have a higher chance of being stone free after the procedure. Plus, they do a lot more with trying to remove the fragments (post procedure you won't have to worry about fragment pain). Also, they can analyze the fragments straight away. Disadvantage is that you have a higher chance of infection, and in all likelihood have to deal with a stent afterwards.

PNL is much more invasive. You end up staying at least overnight in the hospital. Plus, if your Dr says that your physiology is not conducive to the surgery, then go for it. After you wake up from PNL, you have tubes coming from your kidney through your back. Not in the least bit pleasant. It also increases your risk of infection, kidney damage and scarring.

I've had both a lithotripsy (Nov. '07) and a ureteroscopy (just over 3 weeks ago). Prior to the lithotripsy, I had 1 2 centimeter stone in my right kidney. Post lithotripsy, 1 centimeter.(located at the "renal pelvis").

I'm not sure what was worse... the lithotripsy or the ureteroscopy. I had to do a "bowel prep" for the lithotripsy, which was VERY unpleasant. I was put under sedation for the lithotripsy. The discomfort afterwards was not a lot of fun. When you're passing the fragments, of course, it hurts. They did not put a stent between the kidney and bladder.

My experience with ureteroscopy was this:

The ureteroscopy was definitely different. There was no preparation beforehand except for nothing to eat or drink after midnight, because I was going under anethesia.

The anethesiologist did really really well with pain and nausea control, so right after the first procedure (the actual ureteroscopy, plus stent placement), I actually felt pretty good. The stent is irritating to the bladder.. I had it in for 10 days. Only way I can describe the irritation is that it feels ike a bladder infection. The second procedure was shorter (only 1/2 hour in the OR), but ended up being more painful. (only for about 24 hours after or so). You can also have the stent removal done while awake, but I opted not to.

I would see if you can find a doctor who is much more experienced with ureteroscopy. My first doctor wasn't, and was trying to get me to go the PNL route after the lithotripsy. I was glad I did not go that path!

My first Dr, I feel, wasn't as experienced with kidney stones as my second Dr. I was very fortunate to find a urologist that specializes in kidney stones, and is affiliated with Johns Hopkins hospital in Baltimore.

Don't be afraid to ask your doctor for your pain medication!

Good luck in your recovery. I know what you're going through!