Should I Wait
Dr. Josh Stern
Video Transcript
Hi, my name is Josh Stern and I’m a urologist
and a member of the Kidney Stone Collaborative.
We asked the community
of stone patients if they had questions
that they would like answered.
One question that I’ve been asked to answer is, what to do
with that stone that’s small
and in my kidney and doesn’t hurt?
That’s a great question and I know
that it weighs heavy on the mind of a lot of patients.
When is this stone gonna cause pain?
What is it going to interfere with in my life
and when is that gonna happen?
So I review the literature
and what I found is that there was a recent paper that broke
patients with stones like that into two groups.
One group, they removed those stones with surgery
and in the other group they watch them
and to see what happens.
Sure, after about three to four years, about 50%
of patients in the group where they were just watching
that stone ended up in the emergency room and
or needed surgery to remove
that stone which had slipped into the ureter in the group
that had it treated upfront.
Only 15% over the next several years had to go
to the emergency room.
Now there have been other papers
that have looked at the same problem,
and typically the findings are about one in four
to one in five patients with a small stone in the kidney
will end up in the emergency room seeking support
or end up having surgery for that stone
That’s in about three to four years.
And these are for small stones,
typically less than 10 millimeters.
Now interestingly, where
that stone is in your kidney is also important.
If the stone is in the lowest part of the kidney,
it has gravity on its side
and those stones are much less likely to cause you trouble
over the next several years.
I want to thank you for joining us today in this video
and uh, welcome you to look through the rest
of the Kidney Stone collaborative site
and watch other videos from colleagues.
Thank you very much.