Mayo Clinic: How do doctors decide on the best treatment for
kidney stones? When I had a calcium stone, my doctor gave me
medication and told me to drink plenty of water until it
passed. When my mother had one, she went through a procedure
to break up the stone. Why the difference? Also, what makes
these stones so painful?
Treatment for kidney stones depends on a stoneís size, type
and location. As in your case, extra fluids and medication may
be all thatís needed for some small stones. Other treatment
may be necessary when a stone is larger. The pain associated
with kidney stones usually is the result of spasms triggered
by a stone stuck in the ureter, coupled with pressure in the
kidney from urine backup.
stones form from minerals and acid salts. About 85 percent of
kidney stones are calcium-based, typically calcium oxalate.
Less common are uric acid stones, struvite stones and cystine
stones. Doctors use blood and urine tests to find out what
kind of stones are present. If you have passed a stone, a
laboratory analysis also can reveal the makeup of the stone.
uric acid and cystine stones can be dissolved by taking
medication and drinking extra fluids. Calcium-based stones are
different, because they donít dissolve. You have to get them
to pass through your urinary system or have them removed.
extra water can help flush out the urinary system, making it
easier for a small stone to pass. Medication to relax the
muscles in your ureter ó the tube that connects your kidney
to your bladder ó also can help a stone pass more quickly
and with less pain.
stones often can be quite painful. There are several reasons
for that. First, the ureter is small and inflexible, so it canít
stretch to accommodate a stone. Second, when a stone gets into
the ureter, the ureter reacts by clamping down on the stone in
an attempt to squeeze it out. Those spasms can lead to
significant pain. Third, if the stone is blocking the ureter,
urine backs up into the kidney, causing pressure within the
often describe kidney stone pain as flank pain that starts
under the rib cage and goes down toward the testicles in men
or the labia in women. To ease pain, health care providers
often recommend over-the-counter pain relievers for those who
are waiting for a kidney stone to pass. Sometimes, narcotics
also are prescribed.
that are too large to pass through the urinary tract on their
own or stones that are causing other problems, such as
bleeding, kidney damage or urinary tract infections, usually
require more invasive treatment.
procedure that can break up a kidney stone is called
extracorporeal shock wave lithotripsy, or ESWL. It uses sound
waves to create strong vibrations that break the stones into
tiny pieces. Those pieces then pass out of the body in urine.
option to remove a stone in the ureter or kidney is a
procedure in which a thin, lighted tube, called a ureteroscope,
equipped with a camera is passed through the urethra and
bladder to the ureter. Once the stone is located, special
tools can snare the stone or break it into pieces that pass in
stone is particularly large, minimally invasive surgery may be
necessary. A procedure called percutaneous nephrolithotomy
involves surgically removing a kidney stone using small
telescopes and instruments inserted through a small half-inch
incision in the back.
you have a history of kidney stones, if you havenít already
done so, talk with your health care provider about strategies
you can use to help prevent stones in the future. In many
cases, dietary changes, an increase in fluids and, sometimes,
medication can help reduce the risk of kidney stones.