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Elliot Ruff
Elliot Ruff,
Category: Urology
Satisfied Customers: 1495
Experience:  GP at Whitstable Medical Practice
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I am 39 years old male. I have a past medical history of

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Hi Doctor,I am 39 years old male.I have a past medical history of renal stones. The first time I had one was back in 2015 where I had a 4mm in in my lft loin, as far as I remember. I passed that naturally.2 years later. I was diagnosed with a 13mm stone on my right loin, which was removed via EWSL. Within the same day of the procedure I ended up with severe pain and went back to A&E and prescribed 100mg Deflonac, suppositories to be taken once a day.If I remember correct I had another scan to see if anymore stones are present and this was around last year. And I was told, that I have bilateral stones and are relatively small and will pass naturally.Around march time I went to the Doctor complaining of the need to urinate, even though I have emptied my bladder. I would still get the urge to go again, but nothing would come out.So they performed a ultra sound to check if I had a full bladder and then they done a Uroflow test, which the results were abnormal. The urologist suggested that I should have a cystoscopy performed. So, I opted in to have it done under general Anaesthesia. He was certain that it is due to a urethral stricture. This was now cancelled, due to covid 19 lock down, which occurred in the UK.At the moment whilst I was working from home in June. I passed a stone which was on my loft loin. At the point of passing the stone, I had pain in the urethra and gross haematuria associated with that. Went to A&E and as they quoted that it has passed after they performed a CT. However, to this day I never felt that stone coming out or even see it come out.48 hours ago, I ended up with pain on my right loin. I went to A&E and it was confirmed that I have a 5mm stone. At first an ultra sound was performed and the result was that, the ureter is dilated. The Doctor then decided to have a CT done.CT scan showed that the 5mm stone is sitting on the upper ureter with partial blockage (Hydronephrosis) and there is a slight swelling of the kidney. However, the kidney can still filter waste.I was then discharged and was informed that, if I have any change in circumstances such as, chills, vomiting or fever, then I should go back. I assume this is down to because of [email protected] 4:30am I decided to go to bed. within an hour I turned in my sleep and due to that I ended with severe pain for like 5 to 10 mins. This pain subsided after that and within a few hours I was pain free.Spoke to the GP and he stated that stone would move and that this is normal, but also good news. As it’s best to for the stone to come out naturally, then having a procedure done.Since today morning 4am (BST) I have noticed gross haematuria. The urine was light red and that could be because that I had a lot of water, hence the colour was light red.
The same morning, I did masturbate. Even though I went to the urinate I never paid any attention to the urine.However, when I woke up 11am, and went for the first urination I have noticed that it has discolouration. Now, this could be due to dyhradation but it definetly did not look at [email protected] 09:20 I went to urinate again and the colour of the urine looks cola coloured to me. I haven't had much water today I have to admit, but to me it does seem as though there is haematuria present. I have been having Groin pain in the last 24 hours. And I am familiar with the Loin to Groin pain with kidney stones.Spoke to GP and they said, I should go to A&E, if have visible red blood that is red in colour. The GP has prescribed me Naproxen 500MG 28 days tablets to be taken twice a day orally after meals
Today (16th sept) I have now developed with heavy groin pain and no loin pain. I have had to take paracetamol which has sort of helped. However, the pain is in waves, whereby it will increase and decrease. Just now @ 2000 hours I have taken one tablet of Naproxen after a meal.
I have also noticed that urine does seem to looking normal now and bleeding is visible at all.So, my questions are:a. Past medical history has shown that when bleeding does occur with stones, it generally tends to stop. So could the bleeding be because of the stone moving?
b. Is there a possibility that masturbation could have aggravated it and hence the bleeding?
c. Would loin pain occur simultaneously with groin? Or would it be as a separate event? Meaning that if I have loin I would not get groin and vice versa.
d. Am I getting groin pain because, the stone is at the point of entering the bladder or because the stone is lodged somewhere and hence this groin pain is present?
e. Can CT scan be able to see prostate and rule out any palpable mass? I haven’t checked if there was any blood in sperm.
f. Family member suggested that filtered water helps best with kidney stones and I was wondering what is your opinion in this regard?
g. Should I go to emergency department and have it evaluated?Look forward to hearing from you.Regards,

Good evening, thank you for contacting us this evening. I am sorry to hear you have been experiencing stones.

In answer to your questions

a. Yes bleeding can be from the trauma of stones and should subside. The importance is drinking plenty and seeking attention if it is not settling or you develop a difficulty in passing urine.

b. Masterbation is unlikely to have had any affect on this.

c. The area of the pain is dependent on the position of the stone. But pain can radiate also, meaning pain from a stone higher up can lead to radiation of pain in the groin - therefore cannot take a huge amount away from this.

d.yes, there is a good chance this is the case, but some assumption needed here.

e. CT can tell you the size of the prostate, however not accurate at assessing prostate pathology - an MRI is gold standard for this.

f. It depends on the cause of your stones - there are different types of stones, calcium, uric acid, therefore filtered water may help, but make no difference if yours are not calcium.

g. If the pain is not subsiding, you feel unwell, you feel the blood has continued without sign of improving then yes, but if not, your GP should refer you to the stone clinic to arrange further evaluation and future management of this.

I hope this is of some help to you, please feel free to ask any further questions.

Customer: replied 2 days ago.
Hi Doctor,Thank you for the response.Today I do not have any signs of Hematuria at all and urine does look as though it has gone back to normal
itself.I did forget mention is that my past medical history does suggest that I do produce calcium oxlate stones. So should aim I to drink filtered water? If yes, then how much help would it really give with regards ***** ***** stone being able to pass through? i.e would it speed it up the process in any way shape or form?Should I opt for an MRI to be done? or would that be OTT considering my age? I am aware that age plays a big part in prostate related issues such as BPH and oncology.what are the chances a 5mm could become lodged in the urethra? I only ask this because I do not want to be in that circumstances at all.If I was to have a stricture would that cause any issues with stones getting stucked inside the urethra?Thanks Doctor.

If you had a 5mm stone or above, it is unlikely to be able to make it to your Urethra, but if it did you would have a great difficulty passing urine - I have not heard or seen this before.

A stricture would indeed impact stones, and previous stones causing trauma can cause a stricture.

A PSA would be useful as a negative PSA is quite useful

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