I am a Category 3 private pilot and have recently experienced some right sided flank pain which has been diagnosed as a kidney stone. What effect does this have on my flying and what information will Transport Canada require from me or my doctor prior to getting back in the air?

The attack of flank pain that you have endured is termed renal colic and the diagnosis is either renal or ureteral calculus, depending on where the stone is located in the renal system. These do have an implication on flight safety so we require some documentation to ensure firstly, that this is in fact the correct diagnosis, and secondly, that the risk of recurrence is controlled.

The medical requirements for the genito-urinary system are spelled out in the Canadian Aviation Regulations, 424.17(3) and stipulate that "any sequelae of disease of the kidney and urinary tract that is liable to cause incapacitation, in particular, any obstruction due to a stone shall be assessed as unfit unless accredited medical opinion can conclude otherwise".

An attack of renal colic can be quite severe and incapacitating. At Civil Aviation Medicine Branch, we would like to know that the stone has passed and the risk of forming new stones is low. In order to establish this, we usually will request a letter from your attending physician or urologist attesting to this fact. A supporting document would usually include a report of investigation such as an IVP ( Intravenous Pyelogram) or US (ultrasound) to show no residual stone or obstruction. Renal CT scanning is now replacing the other two tests in the investigation of stone disease, because of it’s superior accuracy, however such a test might only be requested in a small number of specific cases.

Once it is determined that the stone has passed, your medical certification maybe reinstated It is recommended that you have the stone analyzed in order to determine if any dietary restrictions may aid in preventing recurrences.