Stephen J. Schueler, M.D.

Overview Incidence Risk Factors drugs Symptoms Evaluation Treatment lithotripsy questions for doctor specialist surgery Home Care pain control warning signs Prevention Outlook Complications Underlying Cause Anatomy

Nephrolithiasis Treatment

General treatment for a kidney stone includes narcotic pain medications, oral fluids, and straining the urine, in order to collect the stone. Larger kidney stones may require treatment with intravenous fluids, antibiotics, medications, and fiberoptic procedures to retrieve stones that become lodged in the ureter. Fortunately, most kidney stones pass through the urinary tract without obstructing the flow of urine.

General treatment for a kidney stone includes:

  • Narcotic pain medications:
    • Can dilate the ureter and encourage the kidney stone to pass
  • Encourage fluid intake
  • Urine is strained and the stone is analyzed, in order to identify the type of stone.
  • Depending on the type of stone, medications may be prescribed that reduce the formation of kidney stones.

When a kidney stone obstructs the flow of urine, treatment may include:

Treatment options for a large kidney stone, or one that is unresponsive to the therapy listed above include:
  • Lithotripsy for kidney stones:
    • High frequency sound waves break up stones in the kidneys
  • Ureteroscopy for kidney stones:
    • A flexible fiberoptic tube is inserted into the bladder, advanced through the ureter, and then to the kidney
    • The stone is removed with the endoscope

Nephrolithiasis Lithotripsy

Very large kidney stones that form in the kidney may require treatment with lithotripsy, during which high frequency sound waves are directed at the kidney. The sound waves break the stones into smaller pieces, so that they can pass through the urinary tract on their own.

In some cases, cystoscopy may be required to remove stone fragments from the bladder.

Nephrolithiasis Questions For Doctor

The following are some important questions to ask before and after treatment for a kidney stone.

Questions to ask before treatment:

  • What are my treatment options?
    • Is surgery an option for me?
  • What are the risks associated with treatment?
  • Do I need to stay in the hospital?
    • How long will I be in the hospital?
  • What are the complications I should watch for?
  • How long will I be on medication?
  • What are the potential side effects of my medication?
  • Does my medication interact with nonprescription medicines or supplements?
  • Should I take my medication with food?

Questions to ask after treatment:
  • Do I need to change my diet?
  • Are there any medications or supplements I should avoid?
  • When can I resume my normal activities?
  • When can I return to work?
  • What else can I do to reduce my risk for complications?
  • What else can I do to reduce my risk for having a kidney stone again?
  • How often will I need to see my doctor for checkups?
  • What local support and other resources are available?

Nephrolithiasis Specialist

Physicians from the following specialties evaluate and treat a kidney stone:

Nephrolithiasis Surgery

The most common method for removing kidney stones requires an ureteroscope. The ureteroscope is a thin, flexible periscope that is placed into the urethra, passed through the bladder, and into the ureter. Once a kidney stone is identified, small tools grasp the stone and remove it from the ureter. The stone may also be broken into smaller pieces, using a laser or ultrasound.

After the procedure, the surgeon may place a stent into the urinary tract. A stent is a thin wire that runs through the ureter, bladder and urethra: one end of the wire is in the kidney, and the other end is outside the body. If the walls of the ureter become swollen, the stent keeps the ureter open, so that urine can continue to flow.

After the stent is placed in the ureter, a person may experience blood in the urine, mild burning during urination, and an increased urge to urinate. The stent is usually removed within a few days after the procedure.

Continue to Nephrolithiasis Home Care

Last Updated: Dec 17, 2010 References
Authors: Stephen J. Schueler, MD; John H. Beckett, MD; D. Scott Gettings, MD
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PubMed Nephrolithiasis References
  1. Hall PM. Preventing kidney stones: calcium restriction not warranted. Cleve Clin J Med. 2002 Nov;69(11):885-8. [12430973]
  2. Pietrow PK, Karellas ME. Medical management of common urinary calculi. Am Fam Physician. 2006 Jul 1;74(1):86-94. [16848382]
  3. Portis AJ, Sundaram CP. Diagnosis and initial management of kidney stones. Am Fam Physician. 2001 Apr 1;63(7):1329-38. [11310648]
  4. Rao PN. Imaging for kidney stones. World J Urol. 2004 Nov;22(5):323-7. [15290203]
  5. Taylor EN, Stampfer MJ, Curhan GC. Obesity, weight gain, and the risk of kidney stones. JAMA. 2005 Jan 26;293(4):455-62. [15671430]
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