Kidney Stone Treatment

What is a kidney stone?
A kidney stone, or "urinary stone," develops when crystals from salt and mineral substances form in the urine. These crystals can combine and grow to form a stone.

The stones can range in size from a grain of salt to a golf ball, or even larger. Some stones may move to other parts of the urinary system, including the bladder and the ureter (the vessel that transports urine from the kidney to the bladder).

What are the symptoms of a kidney stone?
The most common symptoms of kidney stones are blood in the urine and pain. You may not be able to see the blood in your urine, and your doctor will need to test the urine with a dipstick. The stone can cause pain once it passes into the ureter. Typically, the pain starts in the back by the rib cage and travels around to the side as the stone moves. It may also radiate (spread out) into the groin.

Other symptoms include:

Rarely, a stone can cause an infection in the urine by blocking its flow. Cloudy, foul-smelling urine, fever, chills, or weakness may be signs of a serious infection.

How are kidney stones diagnosed?
To determine if you have kidney stones, the doctor will ask you about your diet, use of medication, lifestyle, and your family's medical history.

Several tests are used to look for kidney stones, including abdominal X-ray, ultrasound, intravenous pyelography (IVP), or computed tomography (CT) scan. In IVP, you receive an injection of dye before the X-ray is taken. The dye is used to get a better image of the size and location of the kidney stone.

You may also undergo a urine test to detect very small kidney stones in the urine. The urine is collected and strained, and any stones found in the urine are analyzed to determine their chemical composition.

How are kidney stones treated?
Kidney stones can usually be treated without surgery. Your doctor, or a kidney specialist, may check the chemical composition of the urine by asking you to collect your urine for a full 24 hours. Then, adjustments in your diet and fluid intake may be prescribed to help stop formation of stones. Water intake is the most important step in helping to reduce kidney stone formation. Drinking up to three quarts of fluids a day will cause the urine to be very dilute, and chemicals will have less of a chance crystallizing together and forming stones.

If your kidney stone doesnít pass through your urinary system on its own, your doctor may refer you to a urologist, who can remove stones when they become a problem. The procedures for removing kidney stones include the following:

ESWL (extracorporeal means "outside the body") is a procedure that uses shock waves to smash the kidney stone into tiny pieces that can pass from the body. It is usually used for smaller stones. In ESWL, the patient is placed in a large tub of water. The urologist locates the kidney stone with an X-ray or ultrasound. Shock waves are generated and travel through the water to the kidney area and crush the stone.

ESWL is performed on an outpatient basis and the patient can go home a few hours after the procedure. Side effects include blood in the urine for a few days and bruising in the back (caused by the shock waves).

This is more of a surgical procedure and is intended for larger kidney stones. The urologist makes an incision in the patientís back and inserts an instrument called a nephroscope into the kidney to remove the stone. In some cases, the urologist may need to use ultrasound to break a larger stone into smaller pieces. Following the procedure, the patient remains in the hospital for a few days.
 
  • Ureteroscopy
  • This procedure is performed when the stone is located in the ureter. The urologist slips an instrument called a ureteroscope through the urethra (the tube through which the urine passes) into the bladder and up to the ureter. The urologist can then remove the stone with a device that resembles a cage or use ultrasound shock waves to pulverize the stone.

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    This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional health information, please contact the Center for Consumer Health Information at the Cleveland Clinic (216) 444-3771 or toll-free (800) 223-2273 extension 43771. If you prefer, you may visit www.clevelandclinic.org/health/ or www.clevelandclinicflorida.org. This document was last reviewed on: 7/25/2005

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