I'm a 41 years old male with a family history of kidney stones living in Toronto. About 5 few weeks ago I've been diagnosed with a kidney stone. The CT scan performed on June 22 showed a 4 mm stone located in the upper part of the ureter. Prior to the CT scan, the stone had moved a couple of centimeters down the ureter according to the X-ray. Last week I was finally able to get a urologist to see me. He briefly looked at the CT scan and told me that he would need to perform a ureteroscopy, since the stone was too big and, if it didn't pass in one month, it will probably never will on its own.

I'm originally from Eastern Europe and my best friend over there is a urologist with more than 15 years of clinical experience. According to him, in that country no doctor will EVER perform a ureteroscopy for a 4 mm stone. They believe it's not worth to undertake such a relatively risky and complex procedure for such a small stone before other methods have been tried. For example, they prescribe a medicine that could either soften/dissolve the stone or widen the blood vessels in order to let the stone pass.

I'm under impression that here in North America the alternative methods of stone treatment are not used at all. Currently I have no major pain, the stone seems to be inactive and I would rather avoid a surgery, which always has its own risks (general anesthesia, for example) and which is followed by some very unpleasant and painfull procedures (stent removal).

I would even prefer the shock wave treatment, however he urologist hadn' t offered that option. Another thing - most internet resources suggest that 80% of stones of 4 mm and smaller should pass on its own. My CT scan summaty shows it is 4 mm. What's the reason my urologist claims it's too big and he wants to perform a surgery right away without trying anything else?