Should I Wait or Seek Treatment?

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.