How are kidney stones treated?

Smaller stones have a higher chance of passing spontaneously with adequate pain relief and appropriate medications. In many circumstances these patients will not need surgery and can be safely observed out of hospital. Larger stones, or those that have failed to pass after an appropriate period of observation, will require surgery.

Patients who require surgery for their stones will, in many cases, require placement of a ureteric stent. This involves a quick procedure under general anaesthesia whereby a telescope is placed into the bladder via the urethra. This telescope is then used to pass a wire into the opening of the ureter and up into the kidney, beyond the stone. A long rubber tube is then fed over the wire and released so that it stays in place in the ureter. This tube allows urine to drain past the stone, thereby relieving the pain. There are no cuts on the outside of the body and no wires or tubes coming out of the body.

The patient goes home with the stent and then comes back to have their stone treated. There are two reasons for this: firstly, placing a stent to relieve pain also stops all muscle activity in the ureter, meaning the stone can no longer pass out by itself; secondly, the stent causes the ureter to dilate, making it easier and safer to pass instruments to the level of the stone during subsequent surgery.

When a stone is associated with infection a patient can become very unwell. In most cases they will need to be admitted to hospital for intravenous antibiotics. A tube through the skin (nephrostomy) may be required to bypass the obstructing stone and drain the infected urine from the kidney. Once the infection is under control the stone itself can be treated.