Kidney Stones - Treatment Overview

SYMPTOMS & TREATMENTS

Your first diagnosis of kidney stones often occurs when you see your doctor or go to an emergency room because you are in great pain. Your doctor may suggest that you wait for the stone to pass and take pain medicine or have a procedure to remove the stone.

Most small stones [less than 5 mm (0.2 in)] move out of the body (pass) without the need for any treatment other than taking pain medicine and drinking enough fluids.

  • The smaller a stone is, the more likely it is to pass on its own. About 9 out of every 10 stones smaller than 5 mm (0.2 in) and about 5 out of every 10 stones 5 mm (0.2 in) to 10 mm (0.4 in) pass on their own. Only 1 or 2 out of every 10 kidney stones need more than home treatment.1
  • The average time a stone takes to pass ranges between 1 and 3 weeks, and two-thirds of stones that pass on their own pass within 4 weeks of when the symptoms appeared.2

Not all kidney stones are diagnosed because of immediate symptoms. Your stone may not be causing you pain, and your doctor may find it during a routine exam or an exam for another condition or disease. In this case, you have the same treatment options as noted below.

Treatment for your first stone

If your doctor thinks the stone can pass on its own, and you feel you can deal with the pain, he or she may suggest home treatment, including:

  • Using pain medicine. Nonprescription medicine, such asnonsteroidal anti-inflammatories (NSAIDs), may relieveyour pain. Your doctor can prescribe stronger pain medicine ifneeded.
  • Drinking enough fluids. You'll need to keep drinking waterand other fluids when you are passing a kidney stone. If you don't get enoughfluids, you could getdehydrated. Drink enough fluids to keep your urineclear, about 8 to 10 glasses a day. If you have kidney, heart, or liver diseaseand are on fluid restrictions, talk with your doctor before increasing yourfluid intake.

Your doctor may prescribe medicine to help your body pass the stone. Alpha-blockers have been shown to help kidney stones pass more quickly with very few side effects.5 Ask your doctor if these medicines can help you.

If your pain is too severe, if the stones are blocking the urinary tract Click here to see an illustration., or if you also have an infection, your doctor will probably suggest medical or surgical treatment. Your options are:

  • Extracorporeal shock wave lithotripsy (ESWL). ESWL uses shock waves that pass easily through the body but arestrong enough to break up a kidney stone. This is the most commonly usedmedical treatment for kidney stones. See a picture ofESWLClick here to see an illustration..
  • Ureteroscopy. Thesurgeon passes a very thin telescope tube (ureteroscope) up the urinary tractto the stone's location, where he or she uses instruments to remove the stoneor break it up for easier removal. Occasionally, you may need a small hollowtube (ureteral stent) placed in theureter for a short time to keep it open and drainurine and any stone pieces. Ureteroscopy is often used for stones that havemoved from the kidney to the ureter. See a picture ofureteroscopyClick here to see an illustration..
  • Percutaneous nephrolithotomy or nephrolithotripsy. The surgeon puts a narrowtelescope into the kidney through a cut in your back. He or she then removesthe stone (lithotomy) or breaks it up and removes it (lithotripsy). Thisprocedure may be used if ESWL does not work or if you have a very large stone.See a picture ofnephrolithotomyClick here to see an illustration..
  • Open surgery.The surgeon makes a cut in the side or the belly to reach the kidneys andremove the stone. This treatment is rarely used.
Click here to view a Decision Point.Should I use extracorporeal shock wave lithotripsy (ESWL) for my kidney stones?

Preventing future stones

After you have had a kidney stone, you are more likely to have one again. Almost half of all people who have a stone will have more stones within 5 years unless they take preventive measures.3 You may be able to prevent getting more kidney stones by drinking more fluids and making changes in your diet. If you have risk factors for having more stones, such as a family history of stones, your doctor may suggest medicines that help prevent stones from forming.

What To Think About

Your doctor may ask you to collect your urine for 24 hours after you pass a stone so your urine can be tested to find out the type and cause of the stone. Knowing the type of stone can help determine what you can do to avoid having another.

In rare cases, a person forms kidney stones because the parathyroid glands Click here to see an illustration. produce too much of a hormone, which leads to higher calcium levels and possibly calcium kidney stones. To help prevent stones from coming back, your doctor may suggest surgery to remove a parathyroid gland or glands (parathyroidectomy).

You may require more treatment for your kidney stones if you have continuing problems and:

  • A lot of urinary tractinfections.
  • Decreased kidney function.
  • A singlekidney.
  • Animpaired immune system.
  • Have had a kidneytransplant.
Author: Monica RhodesLast Updated: May 4, 2009
Medical Review: Kathleen Romito, MD - Family Medicine
Philip Belitsky, MD, FRCSC - Urology

1995-2009 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.

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