Post Kidney Stone Passage: Is There Still a Stone and Treatment Options?

Q: Post Kidney Stone Passage: Is There Still a Stone and Treatment Options?

Hello： It is possible that there may still be some stones that need to pass. <br>At this time, taking potassium citrate may not be very effective; using a dilator and staying hydrated would be more practical. <br>However, please be cautious not to drink so much water that it caus

After the expulsion of kidney stones, follow-up care is essential?

Hello Doctor: I finally passed a kidney stone the day before yesterday, which was indeed lodged between the bladder and the urethra.
The stone was approximately 0.7 x 0.4 cm in an oval elongated shape and was identified as an oxalate stone.
Normally, after passing the stone, I should not have any remaining stones, but instead, I have been experiencing a feeling of tightness in my lower left abdomen, similar to what I felt three to four months ago with the previous stone.
I would like to know if it is possible that there are still stones present.
Additionally, can I purchase over-the-counter medications to help manage calcium oxalate stones, such as potassium citrate?

TT, 20~29 year old female. Ask Date: 2019/10/02

Dr. Du Shixi reply Urology

Hello: It is possible that there may still be some stones that need to pass.
At this time, taking potassium citrate may not be very effective; using a dilator and staying hydrated would be more practical.
However, please be cautious not to drink so much water that it causes abdominal bloating.
Wishing you good health.

Reply Date: 2019/10/02

More Info

After successfully passing a kidney stone, it is understandable to have concerns about whether any additional stones remain and what steps to take next. In your case, you mentioned that you passed a 0.7 x 0.4 cm oxalate stone, which is a common type of kidney stone. However, the lingering sensation of tightness in your left lower abdomen raises valid questions about the possibility of residual stones or other underlying issues.

First, it is essential to understand that even after passing a stone, some patients may experience discomfort or a sensation of fullness in the abdomen. This can be due to several factors, including inflammation in the urinary tract, residual fragments of the stone that may not have been expelled, or even muscle spasms in the ureter or bladder. In some cases, the sensation may also be related to changes in urinary habits or the body's response to the recent passage of a stone.

To determine whether any additional stones are present, imaging studies such as an ultrasound or a non-contrast CT scan may be warranted. These imaging techniques can help visualize the urinary tract and identify any remaining stones or obstructions. If you continue to experience discomfort, it is advisable to consult your healthcare provider for further evaluation.

Regarding the management of calcium oxalate stones, dietary modifications and medications can play a significant role in prevention. Potassium citrate is often recommended for patients with calcium oxalate stones, as it can help to alkalinize the urine and reduce stone formation. It is available in prescription form, but some over-the-counter formulations may also contain potassium citrate. However, it is crucial to consult with your healthcare provider before starting any new medications or supplements, as they can provide personalized recommendations based on your medical history and current condition.

In addition to potassium citrate, other dietary changes can help manage calcium oxalate stones. Increasing fluid intake is vital, as it dilutes the urine and helps prevent stone formation. Aim for at least 2 to 3 liters of water daily, depending on your individual needs. Reducing dietary oxalate intake can also be beneficial; foods high in oxalate include spinach, rhubarb, beets, nuts, and chocolate. However, it is essential to maintain a balanced diet, so consult with a dietitian or your healthcare provider for tailored advice.

Furthermore, maintaining adequate calcium intake is crucial, as low calcium diets can paradoxically increase the risk of stone formation. Instead of avoiding calcium-rich foods, focus on consuming them in moderation, as dietary calcium can bind to oxalate in the intestines and reduce its absorption.

In summary, while it is possible that you may still have residual stones or other issues contributing to your discomfort, imaging studies can provide clarity. Additionally, potassium citrate and dietary modifications can be effective strategies for managing calcium oxalate stones. Always consult with your healthcare provider before making any changes to your treatment plan or starting new medications. They can guide you through the best options for your specific situation and help ensure that you remain stone-free in the future.

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