radiation question, possible kidney stones.

[Jewelrylady]

my husband had SBRT (prostate, few spots on spine, and one rib) in August and November 2023 with no side effects. He recently had lab work and It showed blood in urine, high protein, and crystals. He had an ultrasound to rule out kidney stones and it showed nothing so he is now scheduled for a Uro CT scan with contrast to make sure no kidney stones. He has had kidney stones in the past and that’s what it has felt like (low back pain). Is this too much radiation? Is this too soon after SBRT? Has anyone had a CT scan after having SBRT? Any problems? Thanks.

[Nusch]

I’m not a doctor but if I would be in this situation Inwould go for CT. It’s a matter of priority.

[Tall_Allen]

No problem. CT is a drop in the bucket compared to his SBRT. Just avoid cystoscopy.

[Jewelrylady in reply to Tall_Allen]

CT scheduled in a few weeks.

[daysbetween in reply to Tall_Allen]

What is the risk of cystoscopy ? I was diagnosed with a kidney stone over the weekend, and they talked about going in through a catheter to "grab it" if I didnt pass it.

[Tall_Allen in reply to daysbetween]

The risk is that the urethra tissue is friable from the radiation and prone to tearing from instrumentation.

[daysbetween in reply to Tall_Allen]

Is that a condition that is permanent ? I have been through SMRT and LDR Brachy back in 2018.

[Tall_Allen in reply to daysbetween]

No- tissues strengthen over time.

[Jewelrylady in reply to daysbetween]

What did you decide to do about your kidney stone. The doctor talked to my husband about having a ureteroscopy.

[daysbetween in reply to Jewelrylady]

I passed my kidney stone last friday so no procedure was necessary.

[Jewelrylady in reply to daysbetween]

Lucky you! I hope it wasn’t too painful.

[daysbetween in reply to Jewelrylady]

Most of the pain had come before my post as the stone worked it's way down my ureter. The last step before passing was more relief than anything else.

[Jewelrylady in reply to daysbetween]

My husband has 3 stones. 3mm in one ureter, 6mm in other ureter and one in kidney. All nonobstructing. The procedure to get them out makes me nervous!

[daysbetween in reply to Jewelrylady]

Tell him drink water and then drink some more ! I just about doubled my water intake prior to passing the stone

[j-o-h-n]

If he had stones before........... he knows the pain............. I've had several right and left....and I know the pain........If stones, hopefully he passes them/it quickly. Try jumping up and down (or ride a horse) to help dislodge the stone(s). Plenty of water..... and more water and more water and some cranberry juice.....

Good Luck, Good Health and Good Humor.

j-o-h-n

[Ab75]

How is his kidney function? I had a ct scan earlier this year with contrast and I have protien in my urine since the scan. If his kidney function is degraded I would inquire about the contrast.

[Jewelrylady]

UPDATE: husband had urinalysis today and there were several abnormal results: Protein - Trace. Last time it was 1+; Blood 2+, last time it was 3+; WBC 3-5 abnormal, last time it was 0-2; RBC 11-20 abnormal, last time >50. Any thoughts or interpretation of urinalysis and CT is appreciated. He won’t meet with urologist until next week. It looks like he does have some kidney stones, but are they bad enough to do something now?

He also had CT with contrast:

1. Non obstructing stones in the distal left and right ureters, and nonobstructing stone in the lower pole left kidney are likely sources of microscopic hematuria.

2. Prostate cancer status post radiation treatment, and circumferential urinary bladder wall thickening from radiation treatment effect and/or outlet obstruction are additional potential sources of hematuria. These are grossly unchanged from the PET CT in June 2023. No obvious extraprostatic spread or distant metastasis.

Kidneys: Demonstrate symmetric nephrograms and excretion. Punctate nonobstructing stone in the lower pole left kidney. 3mm no obstructing stone in the distal left ureter. 6mm nonobstructing stone in the distal right ureter. There is no hydronephrosis. There are right renal cysts and is 6.5 cm left renal cortical cyst. The left and right ureter is completely opacified. There are no soft tissue masses in the renal collecting systems or ureters.

Bladder/Pelvis: circumferential urinary bladder wall thickening. Suble 1.9cm hypoenhancing region in the left posterior peripheral zone corresponding to prostate cancer found on PET. Radiation fiducial markers in the prostate.

Everything else was unremarkable.