What is the Treatment of Kidney Stones?

The treatment of kidney stones is based on the based on the type, size, location and cause. As most stones are small and can pass through the urinary tract on their own, watchful waiting is the most common treatment. If a stone is big and does not pass on its own, your doctor may suggest minimally invasive procedures to remove the stone. Read to know more on treatment of kidney stones.

Watchful Waiting

Most stones (about 85%) are small and they pass through the urinary tract during urination usually within 72 hours after the symptoms start. If you have symptoms due to the stone, your doctor after evaluation will advise you to drink plenty of water (as much as 2 to 3 quarts per day), stay physically active, take pain relieving medicines if required and wait for the stone to pass. You may be prescribed medicines to facilitate the passage of the stone by relaxing the ureter.

If the stone is small enough to pass without medical treatment, your doctor may advise you to urinate through a strainer, so the stone can be retrieved. This can help to analyse the stone for its mineral composition, further treatment and suggestions for preventive measures.
Watchful waiting is not recommended if you have symptoms suggestive of urinary tract infection, fever, and severe pain that that cannot be controlled by pain medication, or persistent nausea and vomiting.

Surgery

If the stone is too large to pass on its own through the urinary tract, your doctor may recommend surgical treatment. Some other reasons to influence the decision towards surgical treatment include bleeding, kidney damage or ongoing urinary tract infections due to the stone.

The minimally invasive surgical treatments which are done for stone removal are:

• Extracorporeal shock wave lithotripsy (ESWL): In this procedure, shock waves are used to break kidney stones into tiny pieces which can then pass through the urinary tract with urine. This procedure is mostly done on stones about 1 centimetre in size or smaller. The procedure takes about 45 to 60 minutes. During the procedure, the kidney stones are broken in small sand-like particles which are easily passed in the urine in due course of time. You can resume normal activity in a few days. The small sand-like particles may be passed in the urine for several months.
• Percutaneous nephrolithotomy (PNL): This procedure is recommended for people if shock wave lithotripsy is not effective or if the kidney stone is too large for extracorporeal shock wave lithotripsy to be effective. To perform the procedure, the doctor makes a small incision on the back to get access to the kidney and uses an instrument called a nephroscope to break up and extract the stones. The aim is to remove all the stone fragments using the nephroscope without leaving any stone to pass through the urinary tract. You may have to stay in the hospital for one to two days following PNL, and complete recovery may take one to two weeks.
• Ureteroscopic stone removal: This procedure is performed on stones lodged in the ureter or in the kidney. It is an outpatient procedure which is done under general or local anaesthesia. A small instrument called ureteroscope is passed through the bladder into the ureter to break up and capture the stone. Laser may be used in some cases to break the stone. If possible, the fragments are removed during the procedure but some small fragments may be passed by the patient in urine. A small tube (stent) may be placed during the procedure in the ureter to relieve swelling and promote healing.

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