Kidney stones are one of the urological issues that most people have heard of. Even though kidney stones are relatively common, they’re also the snowflakes of the urology world. That’s because no two kidney stones are precisely the same. As such, treatment varies from person to person and from stone to stone. Options for treatment will depend on the patient, size of the stone, and location of the stone.
Small stones
Kidney stones that are on the smaller size can sometimes pass on their own. As long as they’re not causing damage or infection, your doctor may advise for you to wait for it to pass on its own. In most cases, the following three things might be part of this “wait and watch” approach. (1)
- Hydration.
Work with your physician to determine what amount of water you should be aiming to drink daily. For some patients, doctors recommend consuming between 2 and 3 quarts daily to dilute urine. This helps prevent stones from forming in the first place and can aid in the passing of small stones that may have developed. (2)
- Over-the-counter pain relief.
Just because your body can safely pass a smaller stone, doesn’t mean that it will be painless. If your urologist expects that you’ll experience pain, they might recommend a pain reliever like ibuprofen to help ease discomfort.
- Prescription medications.
Typically, the next level of non-invasive medical support comes in the form of a medication that relaxes the muscles of the ureter to make passing a stone easier on the patient.
Large stones
Sometimes stones are too large to safely pass on their own. Unfortunately, if that’s the case, usually they’ll also cause quite a bit of pain. In addition, larger stones can cause bleeding, recurrent UTIs, and kidney damage. (2)
Fortunately, there are several options when it comes to surgical interventions for larger kidney stones. The level of invasiveness varies and depends on the patient, the size of the stone, and the location of the stone.
Shock Wave Lithotripsy (SWL)
This procedure is usually accomplished on an out-patient basis. It involves using x-ray and ultrasound technology to focus shock waves on the kidney stone. This helps break the stone into smaller pieces that will then make their way out of the body during urination. (1)
Ureteroscopy (URS)
This procedure involves inserting a thin scope into the body through the urethra to allow your urologist to see the kidney stone. If it is small enough to remove through the scope, your urologist will use a tool to do so. If it’s too large to pass easily through the scope, your urologist will use a laser or another urological tool to break up the stone so that it can be removed through the scope. In some cases, your surgeon may insert a temporary stent in the ureter to aid in the passage of urine after this procedure. (1)
Percutaneous Nephrolithotomy (PCNL)
More invasive than the other two options, this procedure involves entering the kidney through a small incision (just about 1/2 inch) in the patient’s back. (1) A rigid scope is inserted into the incision, and allows a tool to access the stone, break it up, and suction it out. This is helpful in the case of large stones, because the pieces are removed during the procedure, rather than waiting for the patient to pass them naturally over time.
If none of the above minimally invasive methods are viable in your situation, laparoscopic or robotic surgery might be considered.
Please note that you cannot determine the size of a kidney stone on your own. You shouldn’t attempt to self-treat or “wait it out” without first consulting your physician. In some cases, kidney stones can obstruct the passage of urine or cause infection, fever and chills – which are medical emergencies that should not be ignored.
