My diabetic FIL has kidney stones. Should he opt for surgery post COVID treatment?

Question

Hello doctor,

My father-in-law is a diabetic patient with stones in both kidneys. He had CO-RAD-3 in a CT scan. We have given home treatment separately. After a few days, he has tested negative in the rapid antigen kit.

Then we have taken a CT scan post-COVID-19, and we got results (attached scan report). Please suggest anything we need to be concerned about.

For kidney stones, they have given tablets like Urifast, Urimax D, and Meftalspas. Also, the doctor suggested surgery after six weeks of post-COVID-19 infection. Anything we need to be concerned about here, or will these tablets be enough?

Kindly help us with your suggested inputs.

Answer 1

Hello,

Welcome to icliniq.com.

I have seen the reports (attachment removed to protect patient identity).

The CT (computed tomography) chest report mentions the disappearance of ground glass appearance (in COVID-19-related findings) in all lung segments. It appears that his pneumonia has healed. However, I would request to share details of the COVID-19 diagnosis, reports, and treatments given. Also, please share all other treatment details (diabetes).

As for a kidney stone on a CT scan of the abdomen and pelvis, the stone at the vesicoureteral junction (VUJ) is causing pain and swelling of the kidney entry (hydronephrosis) and has been suggested to be removed.

It is advisable to go for surgery (it is an endoscopic or ureteroscopic removal of the stone, which will require two visits, one for removal and stenting, and the other for removal of stents) if the RT-PCR-based antigen detection (not rapid antigen) test is now negative. The other calculi or stones are in the kidney, are small, and do not need removal unless they descend into the ureter, which may or may not happen later.

The best case is to manage conservatively to attempt hydrotherapy or diuretic-based stone removal (if the diameter is less than 5 mm) if the pain is not disabling, hydronephrosis is not progressing, and if the renal function is not affected. Still, the confirmatory way of removal is by ureteroscopic removal.

However, one must be careful and take complete prophylactic anti-COVID measures (to prevent recurrence) and post -COVID19 treatment before going in for surgery. It is a risk-benefit balance we need to see before this decision.

I hope I have answered your queries.

Please revert in case you have any doubts.

Thank you.