Kidney and Ureteral Stones Treatment

If you have kidney or ureteral stones, your treatment will depend on how large the stones are, how severe your symptoms are , the type of stones and the cause of the stones . Most kidney stones can be managed with fluid intake and pain relievers. Some will require medication to help pass the stones quickly and with less pain. Most people who have stones will not require surgery or medical procedures to remove or destroy the stones.

Treating small stones with mild symptoms

To treat small stones that aren't causing you too much difficulty, your doctor may recommend the following:

  • Drinking water - It is important to drink plenty of fluids when you have kidney or ureteral stones. Most doctors recommend about 2 to 3 liters of water per day (one half to two-thirds of a gallon). This is meant to flush your urinary tract system. Talk with your doctor about how much fluid you should be drinking and whether any of that fluid can be in a form other than plain water.
  • Taking pain relievers - Because passing even small stones can cause pain, your doctor may recommend over-the-counter pain relievers, such as acetaminophen (Tylenol), ibuprofen (Motrin, Advil) or naproxen sodium (Aleve) to help you manage the pain and discomfort.
  • Taking medications to help you pass the stones - Your doctor may recommend a medication called an alpha blocker to help you pass your kidney stones. It helps relax the muscles in your ureter, which should reduce pain and help you pass the stone more quickly.

Treating larger stones or stones with more severe symptoms or risks of complications

If you have large stones or severe symptoms, or the type of stone puts you at higher risk for complications, you may need to have a medical or surgical procedure. Those procedures include:

Shock wave lithotripsy (SWL)

This procedure, also known as extracorporeal shock wave lithotripsy or ESWL, uses a machine called a lithotripter to break up stones. The machine delivers ultrasonic waves through the skin to the stones in order to break them up. The sound waves create vibrations strong enough to shatter stones into pieces that are small enough to be passed through the urinary tract. The procedure can be quite uncomfortable. Some people describe it as feeling like they are being kicked or punched. However, your doctor can offer sedation or anesthesia to help you manage the pain. SWL isn't appropriate for all kidney stones. If you are interested in this type of treatment to manage your kidney stones, talk with your doctor to find out whether it's right for you.

Percutaneous nephrolithotomy (PNL)

This is a surgery to remove large kidney stones. It is done under general anesthesia in the hospital. Nephrolithotomy, also known as endoscopic removal of kidney stones, is done using a tiny, lighted telescope and instruments that are inserted through an incision on your back. If you have this surgery, you will be given general anesthesia during the procedure, and you will stay in the hospital for one or two days. Nephrolithotomy is usually reserved for very large stones or for people who had unsuccessful shock wave lithotripsy (SWL).

Ureteroscopy (URS)

This procedure uses a ureteroscope (a thin tube with a light on it) to locate a stone in the kidney or ureter. During the procedure, the surgeon will insert the ureteroscope into your urethra and through the urinary tract until the stone is located. Once the surgeon can see your stone, he or she can use a tool to either grab the stone and remove it or to break it into tiny pieces you will be able to pass when you urinate. Sometimes surgeons will place a stent into the ureter, which is intended to encourage healing and help relieve swelling. Ureteroscopy can be done under general anesthesia or using local anesthesia. If you're going to have this procedure, your doctor will talk with you about the best anesthesia option for you.

Surgery to remove parathyroid tumors

Some kidney stones are caused by a condition called hyperparathyroidism, which is overactive parathyroid glands. The parathyroid glands produce parathyroid hormone, but when they produce too much, calcium levels in the body can increase. When you have too much calcium in your body, kidney stones may form. Sometimes, hyperparathyroidism is caused by small, non-cancerous tumors that form on the parathyroid glands. These tumors often lead to an overproduction of parathyroid hormone. In this case, removing the tumor from the gland should stop overproduction of the hormones and in turn reduce calcium levels in the body.

If you have any signs or symptoms of kidney or ureteral stones , contact your doctor to set up an appointment to discuss your treatment options.

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