Is dissolving a stone really possible?

[CRYSTAL]

Has anyone had any luck with actually dissolving a cystine stone?

I am asking because I recently had an x-ray done and am told, by my urologist, that I have another stone that is too large to pass. He has recommended surgery within the next 6 months. However, my nephrologist has just started me on Urocit-K and has discussed using other medications that he believes will dissolve it and is recommending holding off on surgery. Normally I would agree but my last surgery was extremely painful (percutaneous lithotripsy - use of a laser through a catheder drilled through my back and directly into my kidney) and I would rather go through ESWL again right away than wait it out and have them tell me in the end that I'd have to go through that again! Both of these doctors are new to me so I have not yet built a trust/relationship with them and am wandering who to turn to. My previous experiences with either of these types of doctors has not been pleasant. I was allergic to Thiola when I tried it many years ago so I am feeling hesitant to try anything else. Any advice or experiences you could share with me in this matter would be greatly appreciated!

Thanks,
Crystal

[Matt Lewis]

Crystal,
while i do not have any 1st hand experience to share with you, i'll share my opinion, so only take it worth a grain of salt. :)

You have two different doctors each wanting to handle the same situation in two different ways. It's no suprise that their approaches are what they are. The situation is analogous to asking a pharmicist and a accupuncture-ist (did i make that word up?) about eliminating pain: one will give you pain killers and the other will stick you with pins. They're each doing what they know best. In your case, the difference is more subtle, but it's still there.
What i'm trying to say with all of this is that both opinions are equally valid and backed by different but real and valid experiences.

On one hand, i don't see ESWL as "surgery", so if that's what your doctor is talking about, i don't think that would be too bad. However, cystine stones are often unresponsive to ESWL, as i'm sure you know. Something to talk over with your doctor; is it worth the chance that it'll do nothing?
On the other hand, i always believe that a temporary passive method is prudent. Trying what your nephrologist is suggesting might have positive effects, and might even weaken the stone to a point at which it would respond very well to ESWL; that's not unheard of. This approach takes more commitment on your part, since it will probably involve a water/diet/medication routein of some kind. If you work at it, i don't see much harm in trying it for a prudent ammount of time. I know you're afraid of the stone getting larger in the meantime, but if you are putting a lot of professional-guided effort in during that time, i doubt things would get worse. The worst i would guess is that you'd be right back to where you were before starting the treatment.
Of course, that's all my pure opinion, based on no real experience. I'll gladly hand it over to anyone with actual experience who would like to address the issue.
i do hope this helps though. :)
matt