Kidney Stone Treatments
Northwestern Medicine Urology treats kidney stones and kidney infections in both adult and pediatric patients. Your physician will decide which treatment options are best for you based on:
- Your age, overall health and medical history
- Extent of the disease, such as stone size, location and composition
- Your tolerance for specific medications, procedures or therapiesv
- Expectations for the course of the disease
You and your physician will discuss your options for treatment and work together to create a treatment plan for you.
Types of Treatment
Medication can help reduce your pain relief until your stone passes.
Your physician can insert a small scope to view and remove smaller stones in the ureter or kidney. How they remove the stone will depend on the size of the stone. They will remove smaller stones with a basket. They will use a laser to break up a stone that is too large to remove with a basket. This is an outpatient surgical procedure with a short recovery time. Your physician may also insert a ureteral stent during this procedure.
A ureteral stent is a plastic piece of tubing that a surgeon will place from the kidney to the bladder. It allows urine to drain until the swelling from a stone removal procedure stops. They may also place a stent if a stone is causing blockage and you have an infection. If your physician leaves the stent on a string, you can remove the stent at home. Your physician may also remove it in the office using a tiny scope. Ureteral stents can be uncomfortable, causing cramping and an urge to urinate. Removing the stent helps with these symptoms.
Shock Wave Lithotripsy
In this outpatient procedure, your physician will use high-energy acoustic pulses to break up the stone into smaller pieces. It does not require a stent. The procedure is usually easy to tolerate and causes little pain. However, you must pass the small fragments over days to weeks after the procedure. There is a risk that not all pieces will pass.
Percutaneous Nephrolithotomy or Mini Percutaneous Nephrolithotomy
This procedure, also called PCNL, involves removing the stone through a small incision in the back. This procedure allows for complete removal of larger stones or stones that are infected. Your physician will make a small incision (1 to 2 centimeters) in your back. Then, they will use an X-ray or ultrasound to better see the kidney. They will use special instruments to break up and then suction out the stones.
PCNL has the highest stone-free rate of any surgical procedure. But recovery time can be longer, generally 2 weeks. With smaller instruments now available, PCNL can be an outpatient procedure or require just a single overnight stay for some patients. The surgeon may temporarily place a small tube that comes out of the incision for drainage, or they may place only a ureteral stent.
Suggestions to Help Prevent Kidney Stones
If you have had a kidney stone, your physician may suggest a full metabolic evaluation. This includes a blood test to check levels of certain substances, such as body pH, calcium, uric acid, phosphorous, sodium and potassium. This information can help your physician recommend some preventive measures to avoid kidney stones in the future.
Some suggestions may include:
- Increasing your daily fluid intake, up to 3 liters of fluid a day
- Eating more foods with citric acid (citrus fruits and certain beverages are a good source of citric acid)
- Limiting salt intake to 1,500 to 2,300 milligrams a day
- Limiting your animal protein intake (aim for portions of 4 ounces or less with meals)
- Taking certain medications to either improve your urinary pH, decrease your urinary calcium levels or decrease your urinary oxalate levels