# Treating kidney stones with high explosives **URL:** \ **Category:** Cecil's Columns/Staff Reports\ **Created:** [July 20, 2012, 3:01pm UTC](https://boards.straightdope.com/t/treating-kidney-stones-with-high-explosives/628857 "2012-07-20T15:01:57Z")\ **Posts on this page:** 20\ **Page:** 1
**Author:** ![sweeteviljesus](https://avatars.discourse-cdn.com/v4/letter/s/898d66/32.png) [@sweeteviljesus](https://boards.straightdope.com/u/sweeteviljesus)\ **Post date:** [July 20, 2012, 3:01pm UTC](https://boards.straightdope.com/t/treating-kidney-stones-with-high-explosives/628857/1 "2012-07-20T15:01:57Z")
Inspired by today’s [column](http://www.straightdope.com/columns/read/3062/will-coke-and-asparagus-cure-kidney-stones): Years ago, I saw a show where a urologist was surgically treating kidney stones using a catheter tipped with a minute amount of PETN or something similar, and using a scope, placed it next to an offending stone and blew it to smithereens which one assumes were small enough to pass without discomfort. Whatever became of this therapy? Thanks, Rob Bring on the “need answer fast” jokes. ---
**Author:** ![TriPolar](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tripolar/32/3008_2.png) [@TriPolar](https://boards.straightdope.com/u/TriPolar)\ **Post date:** [July 20, 2012, 3:31pm UTC](https://boards.straightdope.com/t/treating-kidney-stones-with-high-explosives/628857/2 "2012-07-20T15:31:59Z")
Assuming such a thing were ever real, it would be surpassed by the use of extracorporeal shock wave lithotripsy to break up stones. ---
**Author:** ![Scacarius](https://avatars.discourse-cdn.com/v4/letter/s/48db29/32.png) [@Scacarius](https://boards.straightdope.com/u/Scacarius)\ **Post date:** [July 20, 2012, 3:46pm UTC](https://boards.straightdope.com/t/treating-kidney-stones-with-high-explosives/628857/3 "2012-07-20T15:46:26Z")
“Kidney stones of half a centimeter or less pass spontaneously about 70 percent of the time, and stones up to one centimeter have nearly a 50 percent chance of passing without treatment.” That’s got to be millimeters, right? ---
**Author:** ![Little\_Nemo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/little_nemo/32/3120_2.png) [@Little\_Nemo](https://boards.straightdope.com/u/Little_Nemo)\ **Post date:** [July 20, 2012, 3:49pm UTC](https://boards.straightdope.com/t/treating-kidney-stones-with-high-explosives/628857/4 "2012-07-20T15:49:51Z")
> [@Scacarius](#): > > “Kidney stones of half a centimeter or less pass spontaneously about 70 percent of the time, and stones up to one centimeter have nearly a 50 percent chance of passing without treatment.” > > That’s got to be millimeters, right? I know if I passed a one centimeter kidney stone, I’d want extensive treatment afterwards. ---
**Author:** ![running\_coach](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/running_coach/32/15836_2.png) [@running\_coach](https://boards.straightdope.com/u/running_coach)\ **Post date:** [July 20, 2012, 3:56pm UTC](https://boards.straightdope.com/t/treating-kidney-stones-with-high-explosives/628857/5 "2012-07-20T15:56:22Z")
Next on _Mythbusters._ "Jamie want little tiny boom. " “Am I missing… a kidney?” ---
**Author:** ![njtt](https://avatars.discourse-cdn.com/v4/letter/n/ecd19e/32.png) [@njtt](https://boards.straightdope.com/u/njtt)\ **Post date:** [July 20, 2012, 3:58pm UTC](https://boards.straightdope.com/t/treating-kidney-stones-with-high-explosives/628857/6 "2012-07-20T15:58:29Z")
Extracorporeal shock wave lithotripsy sounds really cool! 😃 ---
**Author:** ![TriPolar](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tripolar/32/3008_2.png) [@TriPolar](https://boards.straightdope.com/u/TriPolar)\ **Post date:** [July 20, 2012, 4:12pm UTC](https://boards.straightdope.com/t/treating-kidney-stones-with-high-explosives/628857/7 "2012-07-20T16:12:10Z")
Sounds way better than passing a 1cm stone. ---
**Author:** ![running\_coach](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/running_coach/32/15836_2.png) [@running\_coach](https://boards.straightdope.com/u/running_coach)\ **Post date:** [July 20, 2012, 4:39pm UTC](https://boards.straightdope.com/t/treating-kidney-stones-with-high-explosives/628857/8 "2012-07-20T16:39:52Z")
> [@runner pat](#): > > Next on _Mythbusters._ > > "Jamie want little tiny boom. " > > “Am I missing… a kidney?” “Blast danger! Clear the urea!” 😃 ---
**Author:** ![Una\_Persson](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/una_persson/32/346_2.png) [@Una\_Persson](https://boards.straightdope.com/u/Una_Persson)\ **Post date:** [July 20, 2012, 5:04pm UTC](https://boards.straightdope.com/t/treating-kidney-stones-with-high-explosives/628857/9 "2012-07-20T17:04:36Z")
> [@Scacarius](#): > > “Kidney stones of half a centimeter or less pass spontaneously about 70 percent of the time, and stones up to one centimeter have nearly a 50 percent chance of passing without treatment.” > > That’s got to be millimeters, right? No. See: Preminger, Glenn M. et al. “2007 Guideline for the Management of Ureteral Calculi” _European urology_ 52 (2007): 1610-1631. > [@](#): > > For stones \<=5 mm, meta-analysis of five patient groups (224 patients) yielded an estimate that 68% would pass spontaneously (95% CI: 46% to 85%). For stones \>5 mm and \<=10 mm, analysis of three groups (104 patients) yielded an estimate that 47% would pass spontaneously (95% CI: 36% to 59%). and Gettman, Matthew T. and Segura, Jospeh W. “Management of ureteric stones: issues and controversies” _BJU International_ 95 (2005): 85-93. > [@](#): > > Stone size and initial stone location influence the likelihood of spontaneous stone passage and guide treatment recommendations. Segura et al. reported spontaneous passage in 29–98% of stones of \<5 mm diameter above the iliac vessels, and 71–98% of stones of \< 5 mm diameter below the iliac vessels. For stones of 5–10 mm diameter, spontaneous passage occurred in 10–53% of proximal calculi and 25–53% of distal calculi. > > In a multivariate analysis of risk factors associated with spontaneous ureteric stone passage, Miller and Kane found that smaller, more distal stones on the right side were more likely to spontaneously pass and require fewer surgical interventions. In a recent report by Coll et al. spontaneous ureteric stone passage rates, regardless of size, were 48%, 60%, 75% and 79% for stones in the proximal, middle and distal ureter or at the vesico-ureteric junction, respectively. Una For the Straight Dope ---
**Author:** ![gnoitall](https://avatars.discourse-cdn.com/v4/letter/g/bb73d2/32.png) [@gnoitall](https://boards.straightdope.com/u/gnoitall)\ **Post date:** [July 20, 2012, 5:33pm UTC](https://boards.straightdope.com/t/treating-kidney-stones-with-high-explosives/628857/10 "2012-07-20T17:33:05Z")
> [@runner pat](#): > > “Blast danger! Clear the urea!” 😃 I am never going to be able to hear “Fire in the hole!” without smirking EVER AGAIN. :eek: ---
**Author:** ![campp](https://avatars.discourse-cdn.com/v4/letter/c/c5a1d2/32.png) [@campp](https://boards.straightdope.com/u/campp)\ **Post date:** [July 20, 2012, 5:48pm UTC](https://boards.straightdope.com/t/treating-kidney-stones-with-high-explosives/628857/11 "2012-07-20T17:48:53Z")
> [@sweeteviljesus](#): > > Inspired by today’s [column](http://www.straightdope.com/columns/read/3062/will-coke-and-asparagus-cure-kidney-stones): > > Years ago, I saw a show where a urologist was surgically treating kidney stones using a catheter tipped with a minute amount of PETN or something similar, and using a scope, placed it next to an offending stone and blew it to smithereens which one assumes were small enough to pass without discomfort. Whatever became of this therapy? > > Thanks, > Rob > > Bring on the “need answer fast” jokes. Laser lithotripsy does exactly this. Very effective therapy. ---
**Author:** ![aruvqan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/aruvqan/32/2891_2.png) [@aruvqan](https://boards.straightdope.com/u/aruvqan)\ **Post date:** [July 20, 2012, 5:56pm UTC](https://boards.straightdope.com/t/treating-kidney-stones-with-high-explosives/628857/12 "2012-07-20T17:56:32Z")
Either way, 1 cm stone or little boom … OUCH! ---
**Author:** ![Scacarius](https://avatars.discourse-cdn.com/v4/letter/s/48db29/32.png) [@Scacarius](https://boards.straightdope.com/u/Scacarius)\ **Post date:** [July 20, 2012, 6:33pm UTC](https://boards.straightdope.com/t/treating-kidney-stones-with-high-explosives/628857/13 "2012-07-20T18:33:14Z")
> [@Una\_Persson](#): > > No. See: > > Preminger, Glenn M. et al. “2007 Guideline for the Management of Ureteral Calculi” _European urology_ 52 (2007): 1610-1631. > > and > > Gettman, Matthew T. and Segura, Jospeh W. “Management of ureteric stones: issues and controversies” _BJU International_ 95 (2005): 85-93. > > Una > For the Straight Dope So, yes, right? All of those references are in millimeters. I’ve passed a kidney stone and the idea of a 1 cm stone is pretty terrifying. ---
**Author:** ![gazpacho](https://avatars.discourse-cdn.com/v4/letter/g/6f9a4e/32.png) [@gazpacho](https://boards.straightdope.com/u/gazpacho)\ **Post date:** [July 20, 2012, 6:44pm UTC](https://boards.straightdope.com/t/treating-kidney-stones-with-high-explosives/628857/14 "2012-07-20T18:44:45Z")
> [@Scacarius](#): > > So, yes, right? All of those references are in millimeters. I’ve passed a kidney stone and the idea of a 1 cm stone is pretty terrifying. You do realize that 10mm is 1cm right? The cited articles talk about stones size from 5 mm to 10 mm. The SD article talks about .5cm to 1cm. Those are the same lengths. ---
**Author:** ![Una\_Persson](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/una_persson/32/346_2.png) [@Una\_Persson](https://boards.straightdope.com/u/Una_Persson)\ **Post date:** [July 20, 2012, 6:53pm UTC](https://boards.straightdope.com/t/treating-kidney-stones-with-high-explosives/628857/15 "2012-07-20T18:53:22Z")
> [@gazpacho](#): > > You do realize that 10mm is 1cm right? The cited articles talk about stones size from 5 mm to 10 mm. The SD article talks about .5cm to 1cm. Those are the same lengths. Exactly. I’ve passed a kidney stone which was about 3x5mm, and it was…horrible. ---
**Author:** ![TriPolar](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tripolar/32/3008_2.png) [@TriPolar](https://boards.straightdope.com/u/TriPolar)\ **Post date:** [July 20, 2012, 6:54pm UTC](https://boards.straightdope.com/t/treating-kidney-stones-with-high-explosives/628857/16 "2012-07-20T18:54:46Z")
> [@gazpacho](#): > > You do realize that 10mm is 1cm right? The cited articles talk about stones size from 5 mm to 10 mm. The SD article talks about .5cm to 1cm. Those are the same lengths. It ain’t the length that distresses me, it’s the width. I’d rather use the explosive than pass a .00001 kilometer stone. ---
**Author:** ![Scacarius](https://avatars.discourse-cdn.com/v4/letter/s/48db29/32.png) [@Scacarius](https://boards.straightdope.com/u/Scacarius)\ **Post date:** [July 20, 2012, 7:46pm UTC](https://boards.straightdope.com/t/treating-kidney-stones-with-high-explosives/628857/17 "2012-07-20T19:46:16Z")
> [@gazpacho](#): > > You do realize that 10mm is 1cm right? The cited articles talk about stones size from 5 mm to 10 mm. The SD article talks about .5cm to 1cm. Those are the same lengths. Well… Never mind, then. ---
**Author:** ![donkeyoatey](https://avatars.discourse-cdn.com/v4/letter/d/e47c2d/32.png) [@donkeyoatey](https://boards.straightdope.com/u/donkeyoatey)\ **Post date:** [July 21, 2012, 1:41am UTC](https://boards.straightdope.com/t/treating-kidney-stones-with-high-explosives/628857/18 "2012-07-21T01:41:02Z")
I have passed two stones that were about 1x1cm and about .3 to .4 thick. This is approximate,of course because they were very irregular in shape. Also passed about 15 more anywhere from 1/4 to 3/4 that size. And what you may think of as passing them is relatively painless, when they rip their way through the kidney the pain is incredible.And, hey,Linus Pauling, you bastard, I stopped taking mega-doses of vitamin C when I found out what was causing them! ---
**Author:** ![wadewood](https://avatars.discourse-cdn.com/v4/letter/w/ba9def/32.png) [@wadewood](https://boards.straightdope.com/u/wadewood)\ **Post date:** [July 21, 2012, 12:58pm UTC](https://boards.straightdope.com/t/treating-kidney-stones-with-high-explosives/628857/19 "2012-07-21T12:58:22Z")
Passing stones does not cause pain. Kidney stones cause pain when they can’t be passed. When stuck they block the flow of urine which causes backpressure on the kidneys, which is very painful. ---
**Author:** ![ftg](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ftg/32/2801_2.png) [@ftg](https://boards.straightdope.com/u/ftg)\ **Post date:** [July 21, 2012, 2:59pm UTC](https://boards.straightdope.com/t/treating-kidney-stones-with-high-explosives/628857/20 "2012-07-21T14:59:55Z")
> [@wadewood](#): > > Passing stones does not cause pain. Kidney stones cause pain when they can’t be passed. When stuck they block the flow of urine which causes backpressure on the kidneys, which is very painful. [False](http://en.wikipedia.org/wiki/Renal_colic). The main pain is usually caused by the body trying to force the stone along. Plus they do sometimes scrape things and help cause an infection, which adds to the fun. [Next page](https://boards.straightdope.com/t/treating-kidney-stones-with-high-explosives/628857.md?page=2)