You have been diagnosed with a kidney or ureteral stone. This section describes the different treatment options which you can discuss with your doctor. Together you can decide which approach is right for you.
Factors that influence the decision include:
- Your symptoms
- Stone characteristics
- Your medical history
- The kind of treatment available at your hospital and the expertise of your doctor
- Your personal preferences and value
Not all stones require treatment. You need treatment if your stone causes discomfort and does not pass naturally with urine. Your doctor may also advise treatment if you have pre-existing medical conditions. There are different treatment methods for emergency and non-emergency situations.
If you have a kidney or ureteral stone which does not cause discomfort, you will generally not receive treatment. Your doctor will give you a time schedule for regular control visits to make sure your condition does not get worse.
If your stone is likely to pass with urine, your doctor can prescribe drugs to ease this process. This is called conservative treatment.
If your stone continues to grow or causes frequent and severe pain, you will get active treatment.
Conservative stone treatment
Most kidney or ureteral stones will leave your body while you urinate. However, depending on the size and location of the stone, it will take you some time to pass the stone. You may suffer from renal colic when the stone moves. If you have a very small stone there is a 95% chance of passing this stone within 6 weeks.
In general, you can keep this in mind:
- The closer the stone is to the bladder, the higher the chance of passing it
- The bigger the stone, the smaller the chance of passing it
There are 2 common conservative treatment options: Medical Expulsive Therapy (MET) and dissolving uric acid stones. In both cases you get medication.
Active stone treatment
Kidney or ureteral stones should be treated if they cause symptoms. There are 3 common ways to remove stones: shock-wave lithotripsy (SWL), ureteroscopy (URS), and percutaneous nephrolithotomy (PCNL).
Which active treatment option is best for you depends on many aspects. The most important factor is the symptoms the stone causes. Based on whether the stone is in your kidney or your ureter, the doctor may recommend different treatment options.
If you don’t have symptoms you may still get treatment in case:
- The stone continues to grow
- You are at high risk of forming another stone
- You have an infection
- Your stone is very large
- You prefer active treatment
Your doctor will recommend removing a stone in the ureter if:
- It seems too big to pass with urine
- You continue to suffer from pain while you take medication
- Your kidneys have stopped or may stop to function properly