Kidney and ureteric stones: symptoms and treatment
Severe colicky pain or blood in the urine may be caused by a stone. Learn the symptoms, how it is diagnosed, the endoscopic and laser treatment options, and how to reduce the chance of recurrence.
Urinary tract stones are among the most common urological conditions. They form when salts and minerals collect in the urine and crystallise inside the kidney, and they may pass into the ureter and cause severe pain.
What are the symptoms?
- Severe, wave-like pain (renal colic) in the flank or lower back that may spread to the lower abdomen or groin.
- Blood in the urine or a change in its colour.
- Burning or a frequent urge to pass urine.
- Nausea and vomiting with the pain.
- A small stone that stays still inside the kidney may cause no symptoms at all.
How is it diagnosed? The doctor relies on examination, a urine test and an ultrasound scan, and may request a non-contrast CT scan of the urinary tract to define the size and position of the stone precisely, and kidney function tests when needed.
Treatment options depend on the size and position of the stone and on the condition of the kidney and the patient:
- Observation and medication: small stones may pass by themselves with plenty of fluids and medicines that ease pain and help passage, under the doctor’s supervision.
- Extracorporeal shock wave lithotripsy (ESWL) for suitable stones.
- Ureteroscopy (URS) with laser lithotripsy: a telescope is passed through the urethra, without a surgical incision, to reach the stone in the ureter or kidney, fragment it and remove it.
- Percutaneous nephrolithotomy (PCNL) for large or complex kidney stones, through a small opening in the flank.
How to reduce the chance of recurrence:
- Drink enough water to keep the urine pale; a urine output of about 2 to 2.5 litres a day is usually advised unless your doctor restricts fluids for a medical reason.
- Cut down on salt and on excessive animal protein.
- Do not cut dietary calcium on your own; restricting it too much can be harmful.
- Have the tests your doctor requests to find out why the stones form and to plan the right prevention.
When to go to the emergency department: if renal colic comes with a high temperature or shivering, if you stop passing urine, if you have persistent vomiting that prevents you taking medicine, or if you have only one kidney. These need urgent assessment.
This is general health information. It does not replace seeing a doctor and having your own condition assessed.
