Sometimes stones do not cause symptoms (silent) and are found during a general health exam. Such stones usually pass unnoticed and may not need treatment. More commonly people with kidney stones experience back pain or blood in their urine and schedule a visit with their physician who will then schedule an x-ray, ultrasound or CT scan to determine the location and size of the kidney stone(s).
Results from these tests help determine the appropriate stone treatment. It is important that if the stone passes, it is sent to a laboratory for tests as this will allow for analysis and development of a long-term treatment and prevention program.
Available Treatment Options
Conservative Management (Spontaneous Passage)
Urinary stones can damage the kidney and urinary tract, therefore elimination of stones is necessary. Fortunately, 70% of all kidney stones pass spontaneously. Patients with smaller stones are advised to try and pass their stone with the aid of hydration and pain medication as needed and to save the passed stone for analysis. Those who do not pass their stone(s) can often be treated without open surgery.
Surgical Intervention
If the stone ends up causing too much pain, becomes too large to pass spontaneously, blocks urine flow, causes tissue damage, or results in some type of urinary tract infection, a form of surgical intervention may be needed.
Extracorporeal Shockwave Lithotripsy (ESWL)
A non-invasive process known as lithotripsy (short for extracorporeal shockwave lithotripsy or ESWL) breaks up stones into smaller sand-like fragments that may pass on their own. This technique is the most frequently used procedure to combat kidney stones. Shock waves are generated outside the body and focused on the target stone. ESWL does not remove their stone. When effective, stones are fragmented to be small enough to pass out of the kidney.
Ureteroscopy
A third type of procedure, called ureteroscopy, allows for treatment of stones in the mid and lower parts of the ureter. A small telescope (ureteroscope) is inserted without an incision through the urethra into the bladder and ureter. The stone can then be removed via a cage-Iike instrument (stone basket), shattered with an ultrasonic probe or the stone(s) can be moved into a region where ESWL is better suited.
The advancements in kidney stone treatment have resulted in open kidney surgery being required for less than one percent of cases.