Exploring Kidney Stone Symptoms and Alternative Testing Methods

Suspected kidney stones?

Hello, Dr.
Hsu.
About 14 years ago, I experienced severe pain in my left lower abdomen and visited a clinic where the doctor diagnosed me with varicocele.
After receiving an injection (presumably a painkiller), the pain subsided.
Since then, I have occasionally felt a vague discomfort in my left flank, which is sometimes not very noticeable.
I underwent X-rays and contrast imaging (5 years ago) as well as an ultrasound, all of which were normal.
Urinalysis showed no blood.
Based on my symptoms, it seems very much like kidney stones.
I haven't had any examinations in the past 5 years, but the discomfort persists intermittently.
I am considering getting checked again, but since I am preparing for pregnancy, I would prefer not to undergo X-rays.
Are there other methods available to check for kidney stones? Thank you.

A Yi, 30~39 year old female. Ask Date: 2008/07/07

Dr. Xu Weikai reply Urology

Hello, regarding kidney stones, they can generally be diagnosed through X-rays, ultrasound, and urine tests.
If all three tests are normal, the likelihood of having stones is low.
If you prefer not to undergo an X-ray, a combination of ultrasound and urine tests can provide nearly 85% diagnostic accuracy.
The sensation of pressure or discomfort can occur in the scrotum or lower back; if it's in the scrotum, it may indicate a varicocele; if it's in the lower back, the specific location is important for diagnosis.
Note that the symptoms could also be related to kidney stones, neuropathic pain, muscle pain, chronic fatigue, among others.
If you have any further questions or need clarification, feel free to ask for more discussion and exploration.
Sincerely, Dr.
Hsu Wei-Kai, Director of Urology, Taitung Hospital, Department of Health, Executive Yuan.

Reply Date: 2008/07/07

More Info

When it comes to kidney stones, understanding the symptoms and exploring alternative testing methods is crucial, especially for individuals who may be preparing for pregnancy and want to avoid radiation exposure from X-rays.
Kidney stones can manifest through various symptoms, including severe pain in the lower back or abdomen, discomfort during urination, and sometimes even nausea or vomiting. In your case, the intermittent dull ache in the left lower back could indeed suggest the presence of kidney stones, especially given your history of acute pain and the previous diagnosis of varicocele. However, since you have had normal imaging studies (X-ray and ultrasound) and urine tests in the past, the likelihood of significant kidney stones may be lower, but it is not impossible.

For non-invasive testing methods, there are several alternatives to X-rays that can be utilized to assess for kidney stones:
1. Ultrasound: This is a highly effective non-invasive method for detecting kidney stones. It uses sound waves to create images of the kidneys and urinary tract. Ultrasound is particularly useful because it does not involve radiation, making it safe for pregnant women. It can help identify the presence of stones and assess any potential obstruction in the urinary tract.

2. CT Scan (without contrast): While CT scans typically involve radiation, a non-contrast CT scan is one of the most sensitive tests for detecting kidney stones. If you are concerned about radiation exposure, discuss with your healthcare provider the possibility of using a low-dose protocol or alternative imaging strategies.

3. Urinalysis: A comprehensive urinalysis can provide valuable information about the presence of crystals, blood, or signs of infection, which can help in diagnosing kidney stones. If you have not had a recent urinalysis, it may be worth repeating to check for any changes.

4. MRI: While not commonly used for kidney stones, MRI can be an option in certain cases, particularly if there are concerns about radiation exposure. However, it is less sensitive than CT scans for stone detection.

5. Observation and Symptom Tracking: Given your history and the intermittent nature of your symptoms, it may also be beneficial to keep a symptom diary. Note when the discomfort occurs, its intensity, and any associated symptoms. This information can help your healthcare provider make a more informed decision about the need for further testing.

In terms of management and prevention, staying well-hydrated is crucial. Drinking plenty of water can help dilute the urine and reduce the risk of stone formation. Additionally, dietary modifications may be necessary depending on the type of stones you are prone to. For example, if you are at risk for calcium oxalate stones, reducing foods high in oxalates (like spinach, nuts, and chocolate) may be beneficial.

If you are considering pregnancy, it is essential to discuss your symptoms and any potential risks with your healthcare provider. They can help you navigate the best testing options while ensuring your health and the health of your future pregnancy.

In summary, while X-rays are a common method for diagnosing kidney stones, there are several non-invasive alternatives available. Ultrasound is particularly recommended for your situation, given your concerns about radiation exposure. Always consult with your healthcare provider to determine the most appropriate testing and management strategies tailored to your specific needs and circumstances.

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