### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
I have been having kidney stones for about the last year and a half. Ive had 2 basket retrievals and 4 lithotrypsi s. My most recent was on 19 july 2012. I had the normal blood in urine and pain for about a week after then a week of feeling fine. Into the 3rd and 4th weeks i started having intense pain and blood in my urine on and off then i felt fine for the next week or so (no blood or pain). In the last 2 days its started again (intense pain and blood in urine) What could be causing this? i have another follow up with my urologist tomorrow. When she spoke to me after the surgery she said the stones had broken up nicely. They were small 1-3mm but she has told me i have very small ureters and it seems the tiniest of flecks cause me alot of pain. Could i have formed another stone already or could it be something else? Im debating on going to the ER tonight or toughing it out till tommorrow. They are limeting my cts because ive had alot in the last year and a half so i dont know if the er would even try one.

### output:

Hi, many thanks for the query! You should do- Metabolic work-up to know & to be able to prevent recurrent stone formation. Give 24 hrs urine sample for examination. For current pain, yes it can be due to another stone fragment. There is no need for CT, Do USG (PUB), Sr. creatinine, Sr. Uric acid. Take antispasmodics, painkillers, diuretics with your doctors' opinion. Wish you a good health. Take care. Regards.