Question to general practitioner Maarten: How can I pass out kidney stones more easily?
Maarten Vasbinder lives in Isaan. His profession is general practitioner, a profession that he mainly practiced in Spain. On Thailandblog he answers questions from readers who live in Thailand.
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Dear Martin,
My question is: "What is the medical name of a drug that can enlarge the opening and outlet of my bladder so that the remaining (smaller?) kidney stones pass more easily?".
My age is almost 83. History: Last year, over a period of a few weeks, I was fortunately finally freed from three kidney stones (with an average diameter of 9mm), after drinking a lot of extra water/beer and pineapple juice. Now I have the same situation, but have the feeling that the current kidney stone(s) is / are slightly larger than the previous ones, so I consulted Google for a possible local medicine that can slightly enlarge my bladder opening and exhaust pipe, but there is no name or brand is mentioned; only consult your (Dutch) GP (which I unfortunately do not have yet). My question to you is “What is the Thai name for this kind of medicine or problem so that I can buy this locally?
In the meantime I drink very many liters of water and pineapple juice to promote a faster flushing, resulting in frequent and frequent urination - but no kidney stones yet to be seen or felt.
My current daily meds include Harnal Ocas for my prostate and Maxgalin 150 for my mild diabetes (being 118). I haven't smoked for 20 years, but enjoy my daily cocktail hour when I drink (two glasses of) a little 285 local rum topped up with lots of Coca Cola. My current weight is 79 kilos, so not overweight.
Lab results and other tests are all normal, so almost healthy by the local doctors and specialists, with normal blood pressure.
Looking forward to better reports, I remain (thanks in advance) from your patient in CM.
Regards,
J.
****
Dear J,
Germans always say with kidney stones: "Saufen und Tanzen", but you probably don't mean that.
Normally, kidney stones cause the most problems as they exit the kidneys, enter the pelvis, and enter the bladder. In those places, the urethra (the tube from kidney to bladder) is narrowed. If the stone gets stuck there, colic occurs and it is very painful. Once the stones have landed in the bladder, they are usually passed out in the urine. If they stick around, they become bladder stones. Bladder stones can also form in the bladder due to the crystallization of urine at high concentrations. Usually they cause little discomfort until they become too large and can block the bladder outlet. They can also cause painful urination.
Harnal Ocas (Tamsulosin) is an agent that widens the inlet and outlet ducts of the bladder. It belongs to the so-called alpha blockers. That's probably what Google is referring to.
Maxgalin (Pregabalin) is a drug used for peripheral neuropathy (nerve pain), a consequence of diabetes. Your sugar level is not affected by it. However, it can cause problems with your kidneys, including kidney stones. A known but uncommon side effect. Stopping this medicine should be done very slowly. Tapering off (slowly reducing) takes at least 3 months.
I don't really have a solution to your problem. For this you must go to the urologist, who will test your urine and make an ultrasound of your (filled) bladder and your kidneys to see what is going on.
Also take your temperature, because a bladder infection cannot be ruled out. If that is the case, then a course of antibiotics is required, for example Monurol (Fosfomicin).
Do you have back problems? A bad back can also sometimes cause bladder problems because of reduced nerve conduction. Even then Maxgalin is sometimes prescribed.
Here is some more literature about Maxgalin (Pregabalin) https://www.apotheek.nl/medicijnen/pregabaline#wat-zijn-mogelijke-bijwerkingen
Yours faithfully,
Dr. Maarten
Do you have a question for Maarten and do you live in Thailand? Send this to the editor: www.thailandblog.nl/contact/ It is important that you provide the correct information (see list at the top of the page).