How are kidney stones treated?
Treatment options include:
- No treatment: Allow stones to pass on their own.
- Medications: To relax the ureter to allow stones to pass.
- Minimally-invasive procedures: Procedure carried out by entering the body through a small incision in the skin or through the body’s natural openings.
No treatment. Depending on the size and location of the kidney stone, sometimes stones can pass through urine on their own. Drinking plenty of liquids helps the kidney stones travel through the urinary tract. Passing the stone may take up to 3 weeks.
Medications. Severe pain, requiring an emergency room visit, can be managed with IV narcotics, IV anti-inflammatory drugs, and IV drugs to manage nausea/vomiting. Stones causing less pain can be managed with an anti-inflammatory drug such as ibuprofen. (Caution: Ask your doctor before taking ibuprofen. This drug can increase the risk of kidney failure if taken while having an acute attack of kidney stones – especially in those who have a history of kidney disease and associated illnesses such as diabetes, hypertension, and obesity.) Other medications may be given to relax the ureter such as tamsulosin (Flomax®) or nifedipine (Adamant®, Procardia®) so that the stones can pass on their own.
Procedures. There are 3 types of minimally invasive surgery – ureteroscopy, shock wave lithotripsy, and percutaneous nephrolithotomy:
- Ureteroscopy. To perform this procedure, a small instrument, called an ureteroscope, is inserted in the urethra, through the bladder, and into the ureter. This instrument allows stones to be seen and then retrieved in a surgical “basket” or broken apart using a laser. These smaller pieces of kidney stones are then more easily able to exit the body through the urinary tract.
- Shock wave lithotripsy. In this procedure, the patient is placed on a special type of surgical table or tub. High-energy shock waves are sent through water to the stone(s) location. The shock waves break apart the stones, which are then more easily able exit the body through the urinary tract.
- Percutaneous nephrolithotomy. When kidney stones can’t be treated by the other procedures – either because there are too many stones, the stones are too large or heavy, or because of their location – percutaneous nephrolithotomy is considered.
In this procedure, a tube is inserted directly into the kidney through a small incision made in your back. If the stones are large, an ultrasound probe and/or laser are inserted and deliver shock waves to the stones to break them apart. Fragments of stones are either suctioned out (so you do not have to pass them through your urine) or removed through a tube (called a nephrostomy) that has been inserted through the skin and into the kidney. This tube drains urine, as well as any small pieces of stone, into a urine collection bag. This procedure requires a short hospital stay (2 to 3 days).
Open stone surgery. Open stone surgery, a major surgical procedure, is rarely performed. It is currently only done in 0.3 to 0.7% of cases.