Kidney stones: diagnosis, symptoms and treatment
Kidney stones are a build-up of salts or minerals in your urine that can eventually develop into stones. Find out more about the symptoms, causes and treatments available for kidney stones.
Everything you need to know about kidney stones
Kidney stones are hard stones that can form in your kidneys. They can develop when there’s a build-up of salts or minerals in your urine. These minerals form crystals, which generally are too small to notice and will pass harmlessly out of your body in urine.
However, these crystals can build up inside your kidney to form a hard kidney stone.
Typical symptoms of kidney stones
You might not always experience symptoms when you have small kidney stones, however, larger kidney stones are often accompanied with the following symptoms:
- pain or aching on one or both sides of your lower back
- sudden waves of pain caused by spasms in your ureter – usually in your back below your ribs, moving round to the front of your tummy
- needing to pee frequently or very urgently
- stinging when you pee
- feeling sick or vomiting
- needing to pass urine frequently or very urgently
These symptoms don’t always mean you have kidney stones, but you should still seek medical advice if you are experiencing them.
Who is at risk of getting Kidney Stones?
Kidney stones are most commonly seen in people between the ages of 30 and 60 and are slightly more common in men.
Although anyone can develop kidney stones, you’re more likely to get them if:
- They run in your family or you’ve had them before
- You regularly suffer from dehydration or live in a hot country
- Drink alcohol to excess
- You consume a high protein diet
- You are taking certain medicines – for example, antiviral medicines called protease inhibitors or certain diuretics (water tablets)
- You take too many antacids, vitamin C, calcium or vitamin D supplements
- You frequently get urinary tract infections
How are kidney stones diagnosed?
If you are experiencing symptoms, contact your GP. Your GP will usually be able to diagnose kidney stones by asking about your symptoms and examining you. They’ll ask about your medical history and will look for signs of dehydration, fever and infection, and check for tenderness where you’re feeling pain.
If your GP suspects kidney stones, they’ll test your urine for signs of infection and blood. They might also ask you to have a blood test.
You may then be referred to a urologist for further tests to confirm the diagnosis and assess the size, location and type of kidney stone you have. These tests might include a CT (computed tomography) scan and/or an ultrasound scan.
What are the best treatments for kidney stones?
Depending on the size, location and type of kidney stone that you have, the following treatments may be recommended to you:
Medicine-based treatments for kidney stones
If your kidney stone is less than 1cm, your urologist may suggest you try medical expulsive therapy (MET). This involves taking medicines called alpha-blockers which help the stone pass out when you pee more quickly by relaxing the muscles in the ureter walls.
If you have uric acid stones, your specialist may suggest taking a medicine to help dissolve them. These medicines change the pH of your urine, to make it more alkaline (less acidic). You will have to monitor the pH of your urine by testing it with a dipstick and adjust the amount of the medicine you take in accordance with the dipstick results.
Surgical treatments for kidney stones
For some people, their kidney stones won’t pass on their own. This is when your urologist may recommend a surgical intervention.
Advances in technology mean surgical treatments for kidney stones are now less invasive, safer and recovery is faster.
The surgical procedures which you might be offered at the Cromwell include:
Lithotripsy is a non-invasive treatment which uses shock waves to break down and remove stones in the kidney and urinary tract. At Cromwell Hospital, we have a dedicated lithotripsy unit to deliver this procedure.
During the treatment, a Specialist Radiographer directs shock waves (pulses of energy) onto the kidney stones in your kidneys or urinary tract, guided by ultrasound. The waves pass through the skin and break down the stones into little fragments, which will come out when you pee.
Lithotripsy is designed to be faster and less invasive than alternative treatments, however, some people might need more than one treatment before the stones break down completely.
The recovery from lithotripsy is rapid – you can often have lithotripsy and go home on the same day.
Holmium laser lithotripsy is a non-invasive procedure, using laser beams to remove stones that are located in the urinary tract.
During the procedure, your urologist will insert a flexible laser fibre through the urethra (the tube that carries urine out of the body) to break up the stones. You will be under anaesthetic throughout the procedure and will require a 1-2 night stay in hospital.
Holmium laser lithotripsy has been shown to be highly effective, regardless of the size, location, and hardness of the stone. It can also be used on patients with multiple stones.
Ureteroscopy involves using an instrument called a ureteroscope to remove stones that are stuck in your ureter. A ureteroscope is a narrow, flexible tube which the doctor will pass it up through your urethra (the tube carrying urine out of the body), into your bladder and then along your ureter. A device on the ureteroscope then breaks up the stone with a laser beam into little bits which the doctor can then safely remove.
The procedure is carried out under anaesthetic, so you may be asked to stay overnight in hospital after the procedure and it will take roughly ten days for you to recover fully.
This is a minimally invasive keyhole surgery to remove large stones from your kidney or upper ureter. You may have this procedure if other methods of removing your kidney stone haven’t worked, or if a stone is causing a serious blockage and infection and needs to be removed urgently .
During the procedure, your surgeon will put a telescopic instrument called a nephroscope through your back and into the kidney where the stone is. The surgeon will then break up the stone using a laser beam or shock waves before pulling it out.
You have this procedure under general anaesthetic and will probably be in hospital for several days whilst you recover.
Choosing the right treatment for you
There are a wealth of treatment options available and sometimes it can be difficult to know which would be the most suitable for you. Our specialists will talk to you about your options and provide a recommended, personalised treatment plan based on your individual situation.