Kidneys & stones

Kidney & ureteric stones

Most small stones pass on their own and some need treatment. Size, position and how the kidney is coping decide which, not the pain alone.

Overview

Stones form when salts and minerals concentrate in the urine and crystallise. A stone can sit quietly in the kidney for years, or move into the ureter and cause sudden, severe renal colic.

Hot summers and too little water make stones more likely to form and to recur, so prevention gets the same attention here as treatment.

Common symptoms

Severe pain in the flank or back that can spread to the lower abdomen or groin
Pain that comes in waves and doesn't ease when you change position
Blood in the urine, visible or found only on testing
Nausea or vomiting with the pain
Frequent or burning urination as the stone nears the bladder

How we diagnose it

Non-contrast CT (CT KUB): The most accurate scan for a stone's size, position and density.
Ultrasound: For follow-up and for checking kidney swelling without radiation.
Urine and blood tests: To check for infection and assess kidney function.
Stone analysis and 24-hour urine: To find the stone type and its cause when stones keep recurring.

Treatment options

Listed from least invasive. Treatment is chosen after assessment and agreed with you.

Watchful waiting with medication
For small stones: pain relief, medicine that relaxes the ureter to help the stone pass, and enough fluids.
Shock-wave lithotripsy (ESWL)
Breaks the stone from outside the body with no incision. Suits stones of a certain size, position and density.
Ureteroscopy with laser
A fine scope reaches the stone through the natural urinary passage, the laser breaks it, and the fragments are removed.
Percutaneous nephrolithotomy (PCNL)
For large kidney stones, through a small opening in the back.
A prevention plan
Enough fluids, less salt and moderate animal protein, plus advice specific to your stone type.

Frequently asked questions

Does every stone need to be broken up?

No. Many stones under 5 mm pass on their own within weeks. The decision depends on size, position, and whether there is a blockage or infection.

Does drinking water prevent stones?

It is the single most important step. Aim for pale urine through the day and around 2.5 litres of urine output daily.

Should I stop dairy?

Usually not. Cutting dietary calcium can raise the risk of some stone types. Advice depends on the type of stone.

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