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).

Return to Kidney Stones

See what others are saying

Comment from: luvsack, 55-64 Male (Patient) Published: March 04

They found a large kidney stone by accident from an x-ray for another problem. It hadn"t moved or caused pain so I was lucky. They used shockwave to blow it up into little pieces and I passed a lot of pieces. I asked if they could prevent them from forming. One of the staff had them 8 times. He said he found a test that had been conducted that showed one teaspoon of concentrated lemon juice a day prevented them. He had been doing it for 6 years and never had any more problems. He was having them ever 12 to 8 months apart before. I tried it but the lemon juice made me urinate too often to be able to go anywhere. I wish I had done it though as now I have another big one they are going to shockwave. The shockwave treatment is not painful or any kind of hassle. They just slightly medicate you and use a video game like device to keep blowing the pieces up until they are all small enough to pass with no pain. The doctor said the device they use is like playing the video game Asteroids, aim at the target and shoot it. Kind of cool in a way.

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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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