Kidney Stone Treatment: what Should I Expect?

Articles On Kidney Stones

Kidney stones usually pass on their own without causing any long-term problems. If they don't, or if you're in a lot of pain, your doctor can break up or remove the crystals.

Your treatment depends on where and how big your stone is and what symptoms you have.

First, You Wait

If your stone doesn’t bother you, your doctor may suggest you wait 2-4 weeks for it to pass on its own. They may tell you to drink extra water to help flush it out of your body.

They may ask you to catch the stone in a strainer when you pee. A lab can test it for minerals to see if medication might prevent more stones.

Medicines

If you’re in discomfort, you can manage your symptoms while you wait for the stone to exit.

Over-the-counter pain relievers such as acetaminophen or ibuprofen can help. You might also need a drug to ease nausea.

Prescription drugs can help:

Calcium channel blockers and alpha-blockers: These relax your ureter, the tube through which pee passes from your kidney to your bladder. A wider ureter will help the stone move more quickly.

Potassium citrate or sodium citrate: Can help keep kidney stones created by uric acid from forming.

Surgery

Sometimes, a stone is too big come out by itself. Your doctor may have to break it up or remove it. They also may do that if you are:

• In a lot of pain
• Have an infection
• Unable to pee because the stone is blocking the flow or stone is blocking urine from one kidney (in which case you might still be able to pee)

Your doctor can choose from several procedures.

Shock wave lithotripsy (SWL). This is the most common treatment in the U.S. It works best for small or medium stones. Your doctor aims high-energy sound waves to break up the kidney stone into little pieces. The shock waves come from outside the body, which is why the procedure sometimes is called extracorporeal SWL.

You will get pain-numbing medicine beforehand, and you usually can go home on the same day.

Ureteroscopy. Your doctor inserts a thin, flexible scope through your urethra, bladder and then into your ureter to reach the stone. If the stone is small, they can use a basket to remove it. If the stone is larger, a laser passed through the scope can break it up.

Percutaneous nephrolithotomy or percutaneous nephrolithotripsy. These similar surgical procedures are options if your stone is large or if other procedures fail to break them down enough. Your doctor uses a thin tube inserted through your skin to reach the stone and them removes (nephrolithotomy) or breaks (nephrolithotripsy) it.

You will be given drugs so you won’t be awake or feel pain. You'll likely have to stay in the hospital for 1-2 days.

Open surgery: This might be an option if your stone is very oversized or your doctor can't take it out with other treatments. You’ll be sedated and not awake. Your surgeon cuts through your side to reach the kidney, then takes the stone out through the opening.

You may need to stay in the hospital for a few days. It can take 4-6 weeks for you to fully recover.

Your surgeon usually will ask a lab to identify the type of stone, so you might be able to take meds to avoid them in the future.

Ask Your Doctor

You have many options to deal with and to prevent a kidney stone. Be sure you understand the pros and cons of each treatment, including doing nothing.

Ask your doctor:

• How long should I wait for my stone to pass on its own?
• How much water should I drink?
• What foods should I eat?
• For which symptoms should I call you?
• What can I do to prevent another stone from forming after treatment?

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