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Seeking Guidance on Management of Ureteric Stone and Mild Hydronephrosis

6/24/2025, 12:30:37 PMMale25-34

Greetings medical professionals, I am a 37-year-old man who recently underwent a CT scan following ongoing discomfort in my left side (flank). The radiology report yielded the following insights: - There is a 3 mm ureteric stone located intramurally on the left, exhibiting a density of 250 HU. - This stone has resulted in mild hydronephrosis, indicated by the dilation of the renal pelvis and upper ureter on the left side. - No stones are present in the kidneys or any other segments of the ureters. - The kidneys maintain normal size, shape, and tissue structure. - The bladder is reported to be normal. - There are no indications of appendicitis, intra-abdominal fluid, or any abnormalities affecting the liver, pancreas, or adrenal glands. - As an incidental finding, there is soft tissue inflammation observed in the left gluteal region alongside some air foci, which may suggest an issue such as cellulitis or a localized infection. I seek clarity on several points: 1. Is it possible for a 3 mm ureteric stone to pass naturally with conservative measures? 2. Should I be worried about the mild hydronephrosis, given that I can currently manage the pain? 3. Are the changes in the gluteal region a cause for concern? 4. What follow-up investigations, treatment options, or medications would you suggest? I greatly appreciate your valuable insights!

Family MedicineInternal MedicinePreventive Medicine

Answers (1)

Cony

6/24/2025, 12:30:54 PM

OpenHealth AI

Thank you for sharing your concerns regarding the ureteric stone and mild hydronephrosis. Let's address your questions clearly:

  1. Passing a 3 mm Ureteric Stone: Yes, a 3 mm stone can often pass through the ureter naturally with conservative measures. Stones of this size have a decent chance of passing without surgical intervention, especially if they are causing only mild symptoms.

  2. Mild Hydronephrosis Concerns: Mild hydronephrosis can occur with a small stone and may not be an immediate concern, especially since you're managing your pain well. However, it’s important to monitor the situation, as significant hydronephrosis can cause complications over time.

  3. Changes in the Gluteal Region: The inflammation and potential infection in that area could warrant attention, particularly if you're experiencing new or worsening symptoms such as increased pain, fever, or swelling.

  4. Follow-Up and Treatment Options: Here are your prioritized next steps:

    • Hydration: Increase your fluid intake to help flush the stone out, aiming for at least 8-10 glasses of water daily, unless otherwise advised. Staying well-hydrated can provide symptomatic relief.

    • Pain Management: Use over-the-counter pain relievers like ibuprofen or acetaminophen based on your tolerance (always follow dosage instructions).

    • Monitor Symptoms: Keep a close eye on any changes in symptoms, such as increasing pain, urinary changes (blood in urine, increased urgency), fever, or symptoms associated with the gluteal region. If these occur, act promptly.

    • Regular Follow-Up: Schedule follow-up imaging and possibly an evaluation of the soft tissue changes in your gluteal area, particularly if you experience symptoms suggesting infection or if the inflammation does not resolve.

    • Potential Medications: If pain persists or you show signs of infection (fever, redness, swelling in the gluteal area), consider discussing antibiotics or other treatments with a health professional.

If symptoms worsen or do not improve, please seek further medical advice to explore additional treatment options, including the possibility of procedures to remove the stone if necessary. Your well-being is important, and monitoring these situations closely is key. Let me know if you have further questions or need additional details!

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