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Dear Dr. Roach: Five years ago, I was diagnosed with a kidney stone while getting an ultrasound for a different reason. A CT scan was ordered, which showed that I had a conglomerate of small stones within a calyceal diverticulum in the posterior mid-pole of my left kidney. My urologist at the time said it wasn't in an area that was amenable to shock wave lithotripsy or a stone removal with a scope.
He said that I could have a wire inserted by interventional radiology, then go to the operating room for a stent that would require an overnight hospital stay. He also said that I could do nothing since I didn't have any symptoms. I chose to do nothing.
I've been fine for five years, but now I'm having issues with urinary tract infections (UTIs), which I usually never get. I made an appointment with the urologist, thinking this might have something to do with the stones. What are your thoughts? -- J.R.
Answer: If you're having UTI issues, then it's very likely that the stones are responsible. The most common pattern with a stone isn't repeat UTIs with different organisms; it's the persistence of an infection despite antibiotics that should've cleared the infection.
Bacteria can live inside the stones or in a biofilm around the stone, which is highly resistant to antibiotics.
Although there are other causes of persistent and recurrent UTIs, it does sound as though your stones may have become symptomatic. I absolutely recommend that you see your urologist to discuss your treatment options. Antibiotics alone generally can't cure persistent infections that are associated with stones. The stone (or conglomerate of stones in your case) needs to be completely removed.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu.