Kidney Diseases

Please help, Kidney stones doctor not helping

10/17/2007

Question:

I am only 18 years old and have been having probelms with my kidneys since 2004. It began when I was babysitting and I had the worst backache. It went away after about fifteen minutes. Months went by before I started having the need to urinate frequently-NO FUN. After being prescribed antibiotics for a UTI on many occasions, I finally went to the ER when I couldnt take it anymore. I waited 4 hours to be seen, and they confirmed that I had a large kidney stone (1.7cm) stuck in my ureter. I had surgery to remove the stone. After recovery, I seemed to be fine. Then my pain returned a year later and 2 more kidney stones were found (7 and 8mm), one treated with lithotripsy.
About four months ago I had the urge to urinate and the same flank pain as before. I went to the urologist and after not getting an appointment until August, I found that I had a 1mm stone in my left kidney. This doesn`t seem to be the cause of the pain, and the doctors don`t think so either. They were being very dismissive of my case, and tried many tests to figure out what was wrong with me. I got an xray to see if it was musculo-skeletal, which was negative for problems. My doctor, after (giving up in my opinion) gave me trial medication for overactive bladder. I have not taken this because I know my body and I know that that is not the reason for my pain.
On the CT scan there was also a 3x3cm ovarian cyst. I know its not your specialty, but I`ve heard that this could be the cause of the urge to urinate. I have an appointment with a gynocologist tomorrow.
I am trying to get a second opinion and a new doctor. I am concerned that waiting around and not getting to the actual problem cannot be good if there really is something wrong with me. I DONT KNOW WHAT ELSE TO DO!
I have heard about scar tissue, possibly from my surgery for the large kidney stone can produce frequent urination...
Please please let me know what you think, and who I should contact for some actual ANSWERS!
Thank you very much.

Answer:

It seems you have repeated episodes of urinary frequency and flank pain. The possibilities for this type of presentation are:

Kidney stones (usually seen on CT scan)

Urinary tract infection (common in female; urine culture and urine microscopy help in diagnosis; also need to rule out reflux of urine from bladder to kidneys)

Crystalluria – means urinary excretion of crystals which ultimately forms kidney stones, but are small enough to be seen by CT scan (needs 24 hr urine evaluation)

Loin Pain Hematuria syndrome (symptom complex of blood in urine, flank pain and may have frequency of urination) – usually due to a defect in glomerular basement membrane

Musculoskeletal pain (usually worst with movements and better with rest)

It is also clear from your history that you are recurrent stone former. The management of this includes management of acute episodes of renal colic/obstruction (by urologist, emergency room) and management of prevention or decrease frequency of future kidney stones (by urologist or nephrologist).
You need to consult nephrologist and urologist for further evaluations of complaints.

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Response by:

Ganesh Shidham, MD
Clinical Assistant Professor
Division of Nephrology
College of Medicine
The Ohio State University