Hi doctor, I am a 25 year old, fairly healthy female. I have been suffering from kidney stones since the age of 15. Mostly the stones would go away on their own without causing any pain. But in the last seven to eight months, I had been suffering from recurrent UTIs and mild pain in the kidney. Around four months back, I got an ultrasound done and found a 10 mm stone in the middle pole and 6 mm stone in the lower pole. At that point, I started on ayurvedic medicine (Calcury). I got an ultrasound done a month later and found the stone size remains the same. But there was no pain or infection of any sort at that time. Last month (I was still asymptomatic) I got a KUB done. It showed only one stone, it did not look like a staghorn stone. A few days later, I got another ultrasound at a different place and according to that doctor, my stone was 17 mm (in the middle pole) and 8 mm (in the lower pole). In the last 15 days, I passed two tiny stones of 3-4 mm which were very soft and pebble-shaped. This made me realize that I may possibly have struvite stones. However, for the last week, I am getting immense pain after a workout. My creatinine was 0.9 last month. I would like to ask you the following questions:- What should be my course of action after this? What is causing this sudden pain? How can I find out what kind of stones do I have? Will shockwave lithotripsy be possible in my case? How accurate is the number 17 mm and 8 mm?
Hi. Since you have got stone problem so early and since you are a recurrent kidney stone former, you need a thorough evaluation to prevent further stone episodes. You should collect the stone you pass in urine and do FTIR (Fourier Transform Infrared) spectroscopy analysis to know the composition. You also need a 24 hours urinary metabolic evaluation to know the exact problem leading to stone formation. The stone size as per ultrasound may not be accurate, so please get a CT KUB (computed tomography of kidneys, ureters, and bladder), to know the exact number and size of the stone. Pain is due to blockage of the ureter when the stone comes down from the kidney. ESWL (extracorporeal shockwave lithotripsy) is definitely a good option for stones up to 15 mm size.