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    Positional flank pain 1 week post PCNL
    sblvxn posted:
    It has been one week since my tubeless perc neph to remove a 1.2 cm stone from the upper calyx of my right kidney. This procedure was done after two previous failed attempts using ESLW and ureteroscopy.

    The surgery went fine, and outside of my body not liking morphine much - post op was noneventful. The stent was removed yesterday morning with no complications, fever and only slightly elevated BP.

    However, over the last three to four days, I am having increasingly painful sharp stabbing pains in my lower right flank. These are made significantly worse when going from upright to prone positions and make breathing painful as well. Further note - no bleeding, redness, hotness in the area of the incision as well as the absence of fever and nausea, bowels moving fine.

    My question/concern is that the pain is positional vs constant or sporadic. When I go to lay down, I will feel this stabbing spasm-like that radiates downward from the incision site/bottom of ribs to the pelvis. Sometimes, they radiate across from right to left, though never crossing the spine. The same is true for shifting position in bed or sitting/standing up. Once in a position, breathing and staying in place will ultimately end in the pains subsiding but the average time for this is 5 minutes. I expect to have some tenderness in the area but these pains are significantly worse. I also contributed these pains to the stent, however after 18 hours, I can tell the stent pains are gone and these are still pronounced. On a pain scale, the background (healing pains) are a 2 and these stabbing ones are a 7-8.

    Any advice on this would be wonderful and I am calling my dr when the office opens up in a few hours here.

    David Maine, MD responded:
    Kim - Thank you for your post. The pain may be attributable to muscle irritation from where the tube was placed which is quite common. This should subside in 3-5 days. Heat and muscle relaxants can be helpful. I would suggest you discuss all of this with your urologist. I hope things turn around quickly. Good luck.

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