Kidney Stones - Treatment

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What is the treatment for kidney stones?

The treatment for the renal colic of a kidney stone includes pain control and hydration. For severe pain, some patients present to the emergency department and often receive intravenous medications including narcotics, anti-inflammatory medications, and medications to control vomiting.

Once the pain is under control in the emergency department, the patient may be discharged home with pain medications and the recommendation to take ibuprofen as an anti-inflammatory. Tamsulosin (Flomax) is a medication often prescribed to help promote stone passage.

In the uncomplicated situation, the stone may be allowed to pass on its own and it may take 2 to 3 weeks or longer. However, there are certain situations where more urgent action may be required.

In patients with a solitary kidney, a kidney stone causing obstruction may lead to kidney failure and emergent referral to a urologist may be required to remove the stone or place a stent to bypass it. The type of procedure depends upon the location of the stone. If the stone is near the junction of the ureter or bladder, ureteroscopy may be an option, where a flexible fiberoptic scope is passed through the urethra into the bladder and ureter to snare the stone with a basket. If that is not possible, a long flexible stent can be passed from the bladder into the kidney to allow urine to drain and to relieve the obstruction. If the stone is high in the ureter near the bladder, an interventional radiologist may need to place a percutaneous nephrostomy or drain through the skin directly into the kidney to allow urine to drain.

Patients with obstructing kidney stones who develop urinary tract infections may need to have a stent or nephrostomy placed to prevent progression of the infection. Urine that is infected that cannot drain will act like an abscess and can cause the patient to become quite ill, often with fevers and chills.

Large stones that are located in the kidney or the upper ureter may be unable to be passed spontaneously. Lithotripsy, sometimes called extracorporeal shockwave lithotripsy (ESWL) uses ultrasound to deliver energy to break up the large stone into smaller stones and debris that then can be passed or captured by ureteroscopy.

Patients with a large stone that fills the whole kidney (staghorn calculi) may require removal using a special instrument inserted through an incision in the skin directly into the kidney (percutaneous nephrolithotomy).

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See what others are saying

Comment from: Alice, 45-54 Female (Patient) Published: June 02

They found a very large kidney stone by accident. It is lodged in on my right side, obstructing my ureter. I have to have the stent placed to surgically remove it. I have had it for quite some time and have lost some kidney function because of it. I never had pain from it though.

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Comment from: mamama, 25-34 Female (Patient) Published: June 09

I am 33 and have had two kidney stones removed so far and currently have a small one waiting to be passed/blown to bits. I had already had appendicitis and gall bladder removal prior to my first kidney stone episode but the kidney stone was much worse pain than either of those. I remember passing out at work from the pain and then waking up in the emergency room (ER) where they told me it was kidney stones and scheduled a lithotripsy after doping me up a bit. The lithotripsy went well and they put a stent in but a day later, it hurt even worse. I tried for a few days to take the pain but I could barely breathe and it was making me almost delirious. So (brace yourself), I went in the bathroom and pulled out my stent. Much better! Doctor wasn't happy when I told him what I did; better than contemplating suicide over the pain. The next episode was after I had my first child, literally, about a week postpartum. Apparently, it had been in there the whole time growing but the fetus kept it from causing too much pain somehow. Again, I had another lithotripsy and another stent, although I warned the doctor about what happened the last time. Sure enough, the same night after surgery, I was rolling around in bed and no position brought any amount of relief. Finally, I told my husband to call an ambulance (which I need to be dying to ask for) and he said he would just take me in the car to the ER. I waited in the ER in a wheelchair for about an hour, trying not to pass out. When I finally got back to triage, my blood pressure was 70/20! Well, that got things moving. In about 5 minutes, I was in a bed with Dilaudid through an IV which was amazing for the pain although my husband says it made me say lots of funny things. That was almost 2 years ago and here we are again for the 3rd go round. Urologist says current one is not big enough to be causing pain quite yet but my back does hurt same place it always does when I have a stone, so we'll see.

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