Kidney Stones and Urinary Issues After Liver Transplant

Kidney urination issues?

Hello doctor, I have previously undergone a liver transplant and have had at least two regular ultrasound examinations each year, all of which have been normal.
Two years ago, during a check-up, the doctor mentioned that I had two stones in my bile duct and advised that as long as I am not in pain, we can just monitor them.
Otherwise, the stones would need to be removed via endoscopy.
After regular monitoring, I was found to have a stone in my right kidney six months ago, and the doctor advised me to drink more water to help it pass.
However, the stone in my right kidney is relatively larger.
On June 26 of this year, during an ultrasound, the doctor noted that the right kidney still appears slightly larger than before and asked if I sometimes hold my urine.
I do sometimes hold it, and the doctor suggested that this might be causing the issue, or it could be due to a stone in the ureter preventing complete urination.
The doctor has scheduled me for an MRI.

Since my surgery in 1989, I have experienced frequent urination, waking up at night to urinate at least once.
The amount of urine varies; sometimes I urinate a lot, and other times just a little.
Can you explain why this is happening? Do I need any additional tests? Also, for the past two months, if I sit with a bent back for more than a minute, I feel a sharp soreness in my lower back when I stand up, but it resolves within a minute.
Additionally, about ten years ago, I started experiencing lower back soreness while lying in bed at night, but it completely goes away once I wake up and get out of bed.
Is this related to my kidneys or could it be due to my sleeping position?

Wenwen, 40~49 year old female. Ask Date: 2018/06/29

Dr. Xu Wencang reply Urology

Return to the outpatient clinic for a detailed discussion with the physician.

Reply Date: 2018/06/29

More Info

Understanding kidney stones and urinary issues, especially in the context of a liver transplant, requires a multifaceted approach. Your history of liver transplantation and the presence of gallstones and kidney stones adds complexity to your urinary symptoms, including frequent urination and lower back pain.

Firstly, it’s important to recognize that kidney stones can lead to various urinary symptoms. The presence of stones in the kidney or ureter can obstruct urine flow, leading to increased frequency of urination, urgency, and sometimes pain. Your doctor’s suggestion to drink more water is a common recommendation, as increased hydration can help flush out smaller stones and prevent new ones from forming. However, if the stones are larger or if there is significant obstruction, further intervention may be necessary.

Frequent urination, especially at night (nocturia), can be attributed to several factors. In your case, the history of kidney stones and potential urinary obstruction could be contributing factors. Additionally, if you are experiencing urinary retention due to the stones or any other underlying condition, this could lead to a sensation of needing to urinate more often. It’s also worth considering that certain medications, particularly those used in post-transplant care, can affect urinary patterns.

The back pain you describe, particularly when sitting for prolonged periods, may not be directly related to your kidneys but could be influenced by your posture or musculoskeletal issues. However, given your history of kidney stones, it’s essential to rule out any renal-related causes. The fact that the pain resolves shortly after standing suggests a possible muscular or postural issue rather than a direct kidney problem.
Regarding your concerns about the need for further testing, the MRI your doctor suggested could provide valuable information about the status of your kidneys and any potential obstructions in the urinary tract. It’s crucial to follow through with this recommendation, especially since you have a history of kidney stones and urinary symptoms that warrant further investigation.

In summary, your situation involves a combination of factors related to your kidney stones, urinary habits, and possibly musculoskeletal issues. It’s essential to maintain open communication with your healthcare provider, follow their recommendations for testing, and discuss any new or worsening symptoms. Regular monitoring and proactive management of your kidney health, especially in the context of your liver transplant, are vital to preventing complications and ensuring your overall well-being.

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