Kidney Stones: Radiation Risks and Treatment Options

Q: Kidney Stones: Radiation Risks and Treatment Options

Hello： 1. Is there still a possibility that this stone can pass on its own? Since the diagnosis, I have been drinking plenty of water every day, but it hasn't passed. --> Some stones are located in positions that are difficult to pass. 2. I occasionally experie

Kidney stones, computed tomography radiation, stone surgery?

Hello Doctor, I was diagnosed with a 0.8 cm kidney stone in November 2020 (ultrasound).
In December 2020, I visited a urologist who performed a KUB (Kidneys, Ureters, Bladder) X-ray and mentioned that there were multiple stones and some white spots, so a CT scan was scheduled.
In November 2021, the CT scan showed a 0.5 cm stone, and the doctor advised to continue monitoring.
However, in February 2021, I experienced back pain and consulted a doctor again.
Another KUB was performed, and the stone had moved down but was still in the kidney.
In May 2021, I switched to a nephrologist because I was concerned about the radiation exposure from repeated abdominal imaging.
An ultrasound showed the stone was still 0.8 cm.
I would like to ask the doctor:
1.
Is there still a possibility for this stone to pass on its own? I have been drinking plenty of water every day since the diagnosis, but I have not passed it.
2.
Occasionally, I experience dull or sharp pain in my lower left abdomen.
Is this related to the stone?
3.
Since I have already undergone a CT scan, two KUBs, and additional X-rays for back pain and dental treatment (three full-mouth and five single-tooth X-rays), as well as two chest X-rays, I am worried about the cumulative radiation exposure from extracorporeal shock wave lithotripsy affecting my future pregnancy.
Would ureteroscopic surgery pose a greater risk to my body? Thank you, doctor, for patiently reading my questions.

pinggu, 20~29 year old female. Ask Date: 2021/05/24

Dr. Du Shixi reply Urology

Hello:
1.
Is there still a possibility that this stone can pass on its own? Since the diagnosis, I have been drinking plenty of water every day, but it hasn't passed.
--> Some stones are located in positions that are difficult to pass.
2.
I occasionally experience dull or sharp pain in my lower left abdomen.
Is this related to the stone? --> If the urine tests are all normal, it is likely not related.
3.
I have already undergone a CT scan, two KUB (Kidneys, Ureters, Bladder) X-rays, and I also had full-body X-rays due to lower back pain.
Additionally, I had three full-mouth and five single-tooth X-rays for root canal treatment, as well as two chest X-rays.
Last year, I also had five chest X-rays, so I am concerned that undergoing extracorporeal shock wave lithotripsy might expose me to too much abdominal radiation, affecting my future pregnancy.
--> The relationship is minimal (you can discuss this with an obstetrician).
4.
However, is ureteroscopic surgery more invasive and harmful to my body? --> Ureteroscopy has its limits and may also have complications.
Please discuss with your attending physician to assess the likelihood of completely addressing the stone and what complications may arise.
Wishing you good health.

Reply Date: 2021/05/24

More Info

Understanding kidney stones and the associated treatment options, particularly in the context of radiation exposure, is crucial for patients navigating their healthcare decisions. Your concerns about the potential risks of radiation from imaging studies and the implications for future health, including fertility, are valid and deserve thorough discussion.

1. Possibility of Spontaneous Passage of Kidney Stones: The likelihood of a kidney stone passing on its own depends on several factors, including its size and location. Generally, stones smaller than 5 mm have a good chance of passing naturally. However, stones that are 0.8 cm (8 mm) in size, like yours, may be less likely to pass without intervention. Drinking plenty of water, as you have been doing, is one of the best strategies to facilitate stone passage. However, if the stone is located in a position that makes it difficult to exit the kidney, it may remain despite your efforts.

2. Left Lower Abdominal Pain: The occasional dull or sharp pain you are experiencing in your left lower abdomen could be related to the kidney stone, especially if it is causing irritation or obstruction in the urinary tract. However, if your urine tests are normal and there are no signs of infection, it may not be directly related to the stone. It’s essential to monitor this symptom and discuss it with your healthcare provider, as they may recommend further imaging or evaluation.

3. Concerns About Radiation Exposure: You have undergone multiple imaging studies, including CT scans and X-rays, which do expose you to some level of radiation. However, the risk associated with these diagnostic procedures is generally considered low, especially when weighed against the benefits of accurate diagnosis and treatment planning. The cumulative radiation exposure from these tests is unlikely to significantly impact your fertility or overall health. Nonetheless, it is always wise to discuss your concerns with your physician, who can provide personalized advice based on your medical history and current health status.

Regarding your concerns about extracorporeal shock wave lithotripsy (ESWL) and ureteroscopy, both procedures have their risks and benefits. ESWL is non-invasive and typically has a lower risk of complications, but it may require multiple sessions, especially for larger stones. Ureteroscopy, while more invasive, can often remove stones in a single session but carries risks such as bleeding, infection, or injury to the urinary tract. Your healthcare provider can help you weigh these options based on the size and location of your stone, as well as your overall health.

In summary, while the risk of radiation from imaging studies is a valid concern, the benefits of accurate diagnosis and treatment often outweigh these risks. It’s essential to maintain open communication with your healthcare team, who can guide you through your treatment options and help you make informed decisions about your health. If you have further questions or concerns, don’t hesitate to reach out to your doctor for more personalized advice.

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