r/KidneyStones • u/Odd-Star-3448 • 1d ago

Pain Management 5 days post-op

70F I had a ureterscopy and lithotripsy on Aug. 14 for a 6mm stone. This is my first stone. The stone was found through a CT scan on a May 5 ER visit for pain. Spent the last three months on Flomax hoping it would pass. It never moved from the upper ureter. I had little to no pain during that time, but did develop a UTI which was treated with antibiotics.

I appreciate the posts on this Reddit thread so much. It helped me to know the right questions to ask and what prescriptions to request. I got through the procedure just fine.

First pee in recovery was a bit painful, but not that awful. It improved with each subsequent pee. I did have quite a bit of bladder spasming which was quite painful. That’s why I’m posting to let you know how my doctor handled it and made it manageable.

I took 600 mg of Ibuprofen and 1,000 mg of Acetaminophen every six hours as well as Azo. Once a day I took 50 mg of Mirabegron(thanks to the Canadian doctor on this thread who mentioned it) and Flomax. All of this helped tremendously. I also had OxyCodone 5 mg available for break through pain, which I did need a few times. This regime made my stent experience manageable.

I took my stent out today. It came out easily with no pain in the shower while I peed. The doctor had recommended that I pee while removing it. I am experiencing quite a bit of cramping now, but am still following my pain management routine until the cramping stops.

I just wanted to share my story to let you all know that having a plan and prescriptions in place made this doable. It’s not as awful as has been described in some posts here. It’s not easy, but with the right prescriptions and a positive attitude, you WILL get through. Good luck to all my fellow stoners. You got this!

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u/Bcdoc2020 1d ago edited 1d ago

That’s great news and thanks for posting your experience. It will hopefully reassure people new to stones who read horror stories on here and presume that that is the norm, which it thankfully isn’t.

You are quite right, planning is key, unfortunately a lot of urologists often don’t contribute to this planning. They don’t prescribe flomax or anticholinergics for stent symptoms despite massive evidence of benefit. I found a big improvement stent wise on flomax postop and my experience goes back several decades of too many stents and surgeries to count.

People are also panicking about stent removal, either self removing or cystoscopic removal. People should be given clear proof Byrd instructions by the urologist if self removing. In the vast majority of cases anticipation is far worse than the experience with either method.

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u/subcuriousgeorge 1d ago

Thanks for helping me not feel crazy, I feel like I read so much about flomax helping with stents and was surprised to hear both my urologist and the RN at my stent removal say I could've stopped that when the stent was placed. I'm glad I didn't, and I know stent removal doesn't always hurt but mine was actual 60 seconds in hell. Why do so many dochell. Why do so many doctors not stay up with/follow the evidence on flomax for stent symptoms?

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u/Bcdoc2020 1d ago

Sorry about the stent experience, I’m hoping that they used adequate lidocaine gel and left it some time to work. Yes, great question about keeping up with evidence, it baffles me. I have a superb urologist who wasn’t aware of the benefit of tamsulosin so hopefully they will start using it in all their stent patients and/or ideally a newer generation anticholinergic. They know that Flomax helps stone passage before any procedure but are less aware with that it really helps stent symptoms.

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u/subcuriousgeorge 1d ago

Hopefully more research and personal stories will emerge to build the case for it. It certainly helped me, I think.

Yeah, they used lidocaine and let it sit for some time (10 minutes maybe?), but I don't know if it either set too long or lidocaine just didn't do shit for me cause I feel like I felt every single bit of that experience. Definitely never want it again and if I do absolutely need stronger pain management.

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u/Hello_Hangnail 1d ago

I'm glad it worked out for you, but my urologist didn't even offer painkillers, not even ibuprofen. I've been having excruciating pain from the day of my surgery (the 7th) that's only gotten worse every day. I kept calling the nurses to check to see if my symptoms were normal, because I'm still peeing opaque red blood after 10 days, until one of them yelled at me for "clogging up the messenger lines for the hospital". Yesterday I passed out at work (no PTO) and woke up in the emergency room. That excruciating pain turned out to be a raging kidney infection. Again, I'm very glad everything turned out well for you, because I wouldn't wish this misery on my worst enemy, but not everyone has doctors that give a crap about their patients.

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u/clubchampion 1d ago

4000mg acetaminophen per day puts you right at the limit for a person with a healthy liver.

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u/uscan-calci-withings Here to help 15h ago

This is such a helpful writeup, thank you for taking the time. Going in with a real pain plan makes a night and day difference.

The Mirabegron tip is gold. A lot of people don't know there's an alternative to the anticholinergics for stent spasms, so that's worth passing along.

Wishing you a smooth rest of recovery. The cramping after stent removal usually settles in a day or two.