What are the treatments for kidney stones?
Most stones that cause renal colic are small and pass out with the urine in a day or so. You should drink plenty of fluids to encourage a good flow of urine. Strong painkillers are often needed to ease the pain until you pass the stone. No other treatment is usually needed.
Some stones become stuck in a kidney or in one of the tubes (the ureters) draining urine from a kidney and cause persistent symptoms or problems. In these cases, the pain usually becomes severe and you may need to be admitted to hospital. There are various treatment options which include the following:
- Extracorporeal shock wave lithotripsy (ESWL) uses high-energy shock waves which are focused on to the stones from a machine outside the body to break up stones. You then pass out the tiny broken fragments when you pass urine.
- Percutaneous nephrolithotomy (PCNL) is used for stones not suitable for ESWL. A thin telescope-like instrument (a nephroscope) is passed through the skin and into the kidney. The stone is broken up and the fragments of stone are removed via the nephroscope. This procedure is usually done under general anaesthetic.
- Ureteroscopy is another treatment that may be used. In this procedure, a thin telescope is passed up into the ureter via the urethra and bladder. Once the stone is seen, a laser is used to break up the stone. This technique is suitable for most types of stone.
- Surgery to remove the stone. This is only needed in a very small number of cases where the above, newer techniques have not worked or are not possible. It may be done if you have a very large stone in your kidney.
Another option for a stone made purely from uric acid (about 1 in 20 stones) is to dissolve the stone. This can be done by drinking plenty of fluids and making the urine alkaline with medication.
How can kidney stones be prevented?
There are various treatment options to remove a stuck stone. About half of people who have a kidney stone develop another one at a later time in their lives. Drinking plenty of water each day may prevent this from happening again.
For the few people who have a high level of certain chemicals in the body, further advice and treatment to reduce the amount of these chemicals may be needed.
Further reading and references
Guidelines on Urolithiasis; European Association of Urology (2015)
CUA guideline on the evaluation and medical management of the kidney stone patient; Canadian Urological Association (November 2016)
Guidelines for acute management of first presentation of renal/ureteric lithiasis (excluding pregnancy); British Association of Urological Surgeons (February 2012)
Renal or ureteric colic - acute; NICE CKS, April 2015 (UK access only)
Macneil F, Bariol S; Urinary stone disease - assessment and management. Aust Fam Physician. 2011 Oct40(10):772-5.
I went to the ER on 11/20/16 when I woke up and saw blood in my urine. They gave me a CT scan and saw multiple 4mm stones in the lower poles of both kidneys. They said that they didn't see any stones...djsp
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