The first step in treating kidney stones is prevention. Prevention measures include avoiding dehydration, drinking plenty of fluids, urinating as soon as possible when the urge is felt, and drinking lemonade, which may have qualities that prevent the formation of kidney stones. Medications may be prescribed to prevent the formation of certain types of kidney stones. Treating hypertension and maintaining a normal weight are also preventive measures.
It is not uncommon for a person with a small kidney stone to be unaware of the condition. A small kidney stone may pass out of the body by itself without any treatment. General treatment of kidney stones includes drinking plenty of fluids to dilute the urine and help flush out a kidney stone. Treatment for pain includes pain medications. For a large kidney stone pain medication and fluids may need to be given intravenously in the hospital.
If a kidney stone does not pass out of the body by itself and becomes lodge in the lower third of the ureter, a variety of procedures are available to remove it or break it up into small pieces. These include cystoscopy, in which specialized instruments are passed in to the ureter through the bladder to withdrawal the stone. A similar procedure may be used to remove or crush the kidney stone using a lazar or ultrasonic probe. A procedure that is performed for a stone located in the upper ureter or in the kidney is called an extracorporeal lithotripsy. In this procedure the kidney stone is crushed by a machine using shock waves.
In rare cases in which the complication of kidney damage has occurred, it may be necessary to remove the affected kidney. This is called a nephrectomy.
The list of treatments mentioned in various sources for Kidney stones includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.
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If you have a stone that will not pass by itself, your doctor may need to take steps to get rid of it. In the past, the only way to remove a problem stone was through surgery.
Now, doctors have new ways to remove problem stones. The following pages describe a few of these methods.
Shock Waves
Your doctor can use a machine to send shock waves directly to the kidney stone. The shock waves break a large stone into small stones that will pass through your urinary system with your urine. The method does not require cutting open the body.
Two types of shock wave machines exist. With one machine, you sit in a tub of water. With the other type of machine, you lie on a table.
The full name for this method is extracorporeal (EKS-trah-kor-POR-ee-ul) shock wave lithotripsy (LITH-oh-TRIP-see). Doctors often call it ESWL for short. Lithotripsy is a Greek word that means stone crushing.
Tunnel Surgery
In this method, the doctor makes a small cut into the patient's back and makes a narrow tunnel through the skin to the stone inside the kidney. With a special instrument that goes through the tunnel, the doctor can find the stone and remove it. The technical name for this method is percutaneous (PER-kyoo-TAY-nee-us) nephrolithotomy (NEF-row-lith-AH-tuh-mee).
Ureteroscope
A ureteroscope (yoo-REE-ter-uh-scope) looks like a long wire. The doctor inserts it into the patient's urethra, passes it up through the bladder, and directs it to the ureter where the stone is located. The ureteroscope has a camera that allows the doctor to see the stone. A cage is used to catch the stone and pull it out.
Ask your doctor which method is right for you. (Source: excerpt from What Are Kidney Stones: NIDDK)
Fortunately, surgery is not usually necessary. Most kidney stones can pass through the urinary system with plenty of water (2 to 3 quarts a day) to help move the stone along. Often, you can stay home during this process, drinking fluids and taking pain medication as needed. The doctor usually asks you to save the passed stone(s) for testing. (You can catch it in a cup or tea strainer used only for this purpose.) (Source: excerpt from Kidney Stones in Adults: NIDDK)
Until recently, surgery to remove a stone was very painful and required a lengthy recovery time (4 to 6 weeks). Today, treatment for these stones is greatly improved, and many options do not require major surgery. Extracorporeal Shockwave Lithotripsy
Extracorporeal shockwave lithotripsy (ESWL) is the most frequently used procedure for the treatment of kidney stones. In ESWL, shock waves that are created outside of the body travel through the skin and body tissues until they hit the dense stones. The stones break down into sand-like particles and are easily passed through the urinary tract in the urine.
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There are several types of ESWL devices. In one device, the patient reclines in a water bath while the shock waves are transmitted. Other devices have a soft cushion on which the patient lies. Most devices use either x-rays or ultrasound to help the surgeon pinpoint the stone during treatment. For most types of ESWL procedures, anesthesia is needed.
In some cases, ESWL may be done on an outpatient basis. Recovery time is short, and most people can resume normal activities in a few days.
Complications may occur with ESWL. Most patients have blood in their urine for a few days after treatment. Bruising and minor discomfort of the back or abdomen from the shock waves are also common. To reduce the risk of complications, doctors usually tell patients to avoid taking aspirin and other drugs that affect blood clotting for several weeks before treatment.
Another complication may occur if the shattered stone particles cause discomfort as they pass through the urinary tract. In some cases, the doctor will insert a small tube called a stent through the bladder into the ureter to help the fragments pass. Sometimes the stone is not completely shattered with one treatment, and additional treatments may be needed. Percutaneous Nephrolithotomy
Sometimes a procedure called percutaneous nephrolithotomy is recommended to remove a stone. This treatment is often used when the stone is quite large or in a location that does not allow effective use of ESWL.
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In this procedure, the surgeon makes a tiny incision in the back and creates a tunnel directly into the kidney. Using an instrument called a nephroscope, the surgeon locates and removes the stone. For large stones, some type of energy probe (ultrasonic or electrohydraulic) may be needed to break the stone into small pieces. Generally, patients stay in the hospital for several days and may have a small tube called a nephrostomy tube left in the kidney during the healing process.
One advantage of percutaneous nephrolithotomy over ESWL is that the surgeon removes the stone fragments instead of relying on their natural passage from the kidney.
Ureteroscopic Stone Removal
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Although some kidney stones in the ureters can be treated with ESWL, ureteroscopy may be needed for mid- and lower-ureter stones. No incision is made in this procedure. Instead, the surgeon passes a small fiberoptic instrument called a ureteroscope through the urethra and bladder into the ureter. The surgeon then locates the stone and either removes it with a cage-like device or shatters it with a special instrument that produces a form of shock wave. A small tube or stent may be left in the ureter for a few days to help the lining of the ureter heal. Before fiber optics made ureteroscopy possible, physicians used a similar "blind basket" extraction method. But this outdated technique should not be used because it may damage the ureters. (Source: excerpt from Kidney Stones in Adults: NIDDK)
Fortunately, most stones can be treated without surgery. Most kidney stones can pass through the urinary system with plenty of water (2 to 3 quarts a day) to help move the stone along. In most cases, a person can stay home during this process, taking pain medicine as needed. The doctor usually asks the patient to save the passed stone(s) for testing. (Source: excerpt from Kidney Stones: NWHIC)
Some type of surgery may be needed to remove a kidney stone if the stone:
does not pass after a reasonable period of time and causes constant pain,
is too large to pass on its own,
blocks the urine flow,
causes ongoing urinary tract infection,
damages the kidney tissue or causes constant bleeding, or
has grown larger (as seen on follow up x-ray studies).
Until recently, surgery to remove a stone was very painful and required a lengthy recovery time (4 to 6 weeks). Today, treatment for these stones is greatly improved. Many options exist that do not require major surgery, like lithotripsy, or sending shock waves to break up the stones. (Source: excerpt from Kidney Stones: NWHIC)
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