Is this how it's usually handled?

My partner has a long history of severe kidney stone disease, and the weird part is she can't reliably feel her stones or an obstruction coming. About 3 years ago they found stones around 3 cm in both kidneys, and the only reason anybody knew was that one of them finally got obstructed and she started having infection symptoms. Before that she'd never had the classic brutal kidney stone pain. She ended up needing roughly 4–5 RIRS/ureteroscopy procedures to get the stones out. The bad news is one stone had quietly blocked her right kidney for a long stretch before anyone caught it, and that did permanent damage — her right kidney only works at about 15% now.

Because of all that, she gets followed with CT scans and imaging about 1–2 times a year. She also did a 24-hour urine collection/metabolic stone workup, and afterward they put her on Alkacit (potassium citrate) to keep her urine pH regulated and alkaline so she forms fewer stones going forward.

This year her non-contrast CT picked up a newly detected elongated “shell-shaped” stone in the left kidney, sitting in the lower pole/inferior calyx. It measures about 8 mm long and 2 mm wide. From what the report says there's no hydronephrosis, no hydroureter, and no obstruction at the moment, and the urology note just recommends coming back for another follow-up CT in 12 months.

We're worried because she doesn't feel her stones until they've already turned into a serious problem — usually when an obstruction brings on infection or inflammation. And since the left kidney is effectively the only one working well for her now, we don't know whether just watching it is really the right call in her case. We've got a phone appointment with her urologist in about 3 weeks, but honestly we're pretty anxious because this is her “good” kidney. Right now she feels completely fine and has zero symptoms.

We live in a Scandinavian country with free public healthcare, and for the most part the care has been really good, so this isn't about distrusting her doctors. We're mainly trying to figure out whether yearly surveillance is the normal approach in a situation like hers, or whether people with a history of silent obstruction and kidney damage sometimes get managed more proactively.