Unconfirmed Kidney Stones: When to See a Urologist and Next Steps - Urology

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When it comes to unconfirmed kidney stones, it is essential to understand the symptoms and the appropriate steps to take for diagnosis and treatment. Based on your description, you experienced significant pain in the left kidney area, which led to a visit to your primary care physician. The findings of hematuria (blood in urine) and elevated white blood cells (WBC) and red blood cells (RBC) suggest that there could be an underlying issue, such as kidney stones or a urinary tract infection (UTI).

1. When to See a Urologist
Given your symptoms and the preliminary findings, it is advisable to consult a urologist for further evaluation. A urologist specializes in conditions related to the urinary tract and male reproductive system, and they can provide a more comprehensive assessment. Here are some reasons why seeing a urologist is important:
- Confirming Diagnosis: While your primary care physician suspects kidney stones, a urologist can conduct further tests, such as imaging studies (ultrasound or CT scan), to confirm the presence of stones and assess their size and location.

- Differentiating Conditions: The urologist can help distinguish between kidney stones and other potential issues, such as a UTI or other renal pathologies, which may require different treatment approaches.

- Treatment Options: If stones are confirmed, the urologist can discuss treatment options, which may include conservative management (increased fluid intake, pain management) or more invasive procedures if the stones are large or causing significant symptoms.


2. How to Know if Stones Have Passed
Determining whether kidney stones have passed can be challenging, especially if you do not see them in your urine. Here are some signs and methods to help you ascertain if the stones have been expelled:
- Symptom Relief: One of the most telling signs that a stone has passed is the relief of pain. If the acute pain subsides significantly, it may indicate that the stone has moved out of the kidney and into the bladder or has been expelled.

- Urine Changes: After passing a stone, you may notice changes in your urine, such as the presence of small particles or sediment. If you can collect your urine in a container, you can look for any stone fragments.

- Follow-Up Imaging: If you are unsure whether the stones have passed, follow-up imaging (such as an ultrasound or CT scan) can provide clarity. Your urologist may recommend this based on your symptoms and initial findings.

- Urine Tests: A urinalysis can help detect the presence of blood or crystals, which may suggest that stones are still present or that they have recently passed.


Additional Considerations
- Hydration: Continue to drink plenty of fluids, as this can help facilitate the passage of stones and reduce the risk of new stone formation.

- Monitoring Symptoms: Keep track of any changes in your symptoms. If you experience worsening pain, fever, or difficulty urinating, seek medical attention promptly.

- Preventive Measures: If you have a history of kidney stones, discuss preventive strategies with your urologist. This may include dietary modifications, medications, or lifestyle changes to reduce the risk of recurrence.

In summary, it is prudent to see a urologist for further evaluation of your symptoms and to confirm whether kidney stones are present. Monitoring your symptoms and following up with appropriate imaging or tests will help determine if the stones have passed and guide your treatment plan. Always communicate openly with your healthcare providers about your concerns and any changes in your condition.