A stone problem usually refers to the formation of a solid mineral deposit in the urinary system. Kidney stones can develop when certain substances in urine become concentrated and form crystals.

A stone may remain inside the kidney without causing symptoms, or it can move into the ureter and interfere with urine flow.

The treatment is not the same for every stone. Doctors generally consider:

• Stone size

• Exact location

• Number of stones

• Stone composition or density

• Degree of obstruction

• Presence of infection

• Pain and other symptoms

• Kidney function

• Previous history of stones

• Overall health

Small stones may pass naturally, while larger, obstructing or very painful stones may require an active procedure.

At Prabhakar Bhurke Clinic, Dr. Sandip Prabhakar Bhurke, super specialist nephrologist and transplant physician, provides specialist kidney evaluation for patients with kidney stones and associated kidney-function concerns.

How Do You Know You May Have a Kidney Stone?

A stone can sometimes be discovered incidentally during an ultrasound or CT scan.

When symptoms occur, they may include:

• Sudden pain in the side or back

• Pain extending toward the lower abdomen or groin

• Blood in the urine

• Pain or burning while urinating

• Frequent urge to urinate

• Nausea or vomiting

• Cloudy or unusual-smelling urine

• Difficulty passing urine

Stone-related pain can come in waves and may change location as the stone moves through the urinary tract.

However, similar symptoms can occur with urinary infections and other conditions, so diagnosis should not be based on symptoms alone.

Does Every Kidney Stone Need Treatment?

No.

Some smaller stones can pass through the urinary tract without a procedure.

When spontaneous passage is considered reasonable, the doctor may recommend observation, appropriate pain management and monitoring.

The decision depends on factors such as the stone's size and location and whether it is causing obstruction, infection, persistent pain or deterioration in kidney function.

A stone that is not causing symptoms may sometimes be monitored rather than removed immediately, depending on its characteristics and the patient's clinical situation.

Stone Problem Treatment Starts With the Right Diagnosis

Before selecting treatment, the doctor needs to know what type of stone problem is present.

Ultrasound

Ultrasound can identify many kidney stones and may show urinary obstruction or swelling of the kidney.

CT Scan

A non-contrast CT scan can provide detailed information about:

• Stone size

• Stone location

• Number of stones

• Stone density

• Urinary obstruction

Urine Examination

Urine testing can look for:

• Blood

• Infection

• Crystals

• Other abnormalities

Blood Tests

Depending on the situation, testing may include:

• Serum creatinine

• eGFR

• Electrolytes

• Calcium

• Uric acid

• Blood count

These investigations help determine whether the stone is affecting kidney function and whether infection or a metabolic risk factor is present.

Treatment Option 1: Observation for Selected Stones

Observation can be appropriate for some small stones that have a reasonable likelihood of passing and are not causing complications.

During this period, the patient may need:

• Follow-up imaging

• Pain management

• Monitoring of urine output

• Instructions about fluid intake

• Medical review if symptoms worsen

Observation is not appropriate for every stone.

A stone causing significant obstruction, infection, uncontrolled pain or deterioration in kidney function may require active treatment instead.

Treatment Option 2: Medicines for Kidney Stones

Medicines can have different roles in stone management.

Pain-Relieving Medicines

Pain medication may be prescribed to control renal colic.

The appropriate medicine depends on kidney function, dehydration status, other illnesses and current medications.

People with CKD should not independently take frequent over-the-counter painkillers without medical advice.

Medicines That May Help Selected Stones Pass

In selected patients, medicines may be used to facilitate passage of certain ureteral stones.

Whether such treatment is appropriate depends on the stone's size, location and the patient's condition.

Medicines for Preventing Future Stones

After the stone type and metabolic risk factors are understood, preventive medicines may be prescribed for selected patients.

Examples can include potassium citrate, thiazide-type medicines or other treatments depending on the specific stone disorder.

These medicines should not be started simply because someone has kidney stones.

Can Kidney Stones Be Treated Without Surgery?

Sometimes.

A small stone may pass naturally, and certain stone types can be managed with specific medical treatment.

However, there is no universal tablet that dissolves or removes every kidney stone.

Most common calcium-based stones do not simply disappear because of a medicine.

Certain uric acid stones may respond to medically supervised urine alkalinization, while prevention medicines may reduce the risk of future stones rather than remove an existing stone.

Therefore, the stone's composition and clinical situation matter.

Treatment Option 3: ESWL or Shock Wave Lithotripsy

Extracorporeal shock wave lithotripsy (ESWL/SWL) uses externally generated shock waves to break a stone into smaller fragments.

The fragments can then pass through the urinary tract.

ESWL may be considered for selected stones, but its suitability depends on:

• Stone size

• Location

• Density

• Kidney anatomy

• Body habitus

• Degree of obstruction

• Other patient-specific factors

Some stones may require more than one treatment session or another procedure if significant fragments remain.

Treatment Option 4: Ureteroscopy and Laser Stone Removal

Ureteroscopy allows a specialist to access a stone through the urinary tract without making a large external incision.

A small scope is guided toward the ureter or kidney.

If necessary, laser energy can fragment the stone into smaller pieces, which may then be removed with specialized instruments or allowed to pass depending on the circumstances.

A temporary ureteral stent may sometimes be placed after the procedure to support urine drainage.

Ureteroscopy can be useful for stones in different parts of the urinary tract, but the exact approach depends on stone characteristics and anatomy.

Treatment Option 5: PCNL for Larger Kidney Stones

For larger or complex kidney stones, percutaneous nephrolithotomy (PCNL) may be considered.

During PCNL, the doctor creates a small access tract through the back into the kidney and uses specialized instruments to fragment and remove the stone.

PCNL is particularly relevant when the stone burden is substantial.

The procedure requires careful assessment of kidney anatomy, stone location, infection status, bleeding risk and overall health.

What If the Stone Is Blocking Urine?

A stone that obstructs urine flow needs careful assessment.

Persistent obstruction can cause:

• Hydronephrosis

• Increasing pain

• Reduced kidney function

• Infection

• Potential kidney damage

The treatment depends on the severity and cause of obstruction.

Sometimes definitive stone removal is performed. In other situations, particularly when urgent drainage is needed, a ureteral stent or nephrostomy may first be used to restore urine flow.

Stone Plus Infection Can Be an Emergency

One of the most important situations in stone disease is an infected obstructed urinary tract.

Warning symptoms can include:

• Fever

• Chills

• Severe flank pain

• Vomiting

• Reduced urine output

• Feeling extremely unwell

• Confusion

A blocked urinary system with infection may require urgent drainage and antibiotic treatment rather than immediate definitive stone removal. Kidney infection treatment may involve antibiotics, while an obstruction may require a procedure to restore drainage.

Do not attempt to manage this situation at home.

Can Drinking Water Remove a Kidney Stone?

Adequate fluid intake can be important for stone prevention and may help selected small stones pass.

However, drinking excessive quantities of water does not guarantee that a large or obstructing stone will pass.

If a stone is blocking urine flow, forcing large amounts of fluid can worsen discomfort and does not mechanically remove the obstruction.

People with kidney failure, heart disease, fluid restrictions or certain other conditions should follow individualized fluid advice.

What Determines the Best Stone Treatment?

There is no single procedure that is suitable for every stone.

A specialist may consider:

Stone Size

Larger stones are less likely to pass naturally and may require a procedure.

Stone Location

A stone in the kidney may be managed differently from a stone lodged in the ureter.

Stone Composition

Different stone types have different prevention and, in selected cases, medical treatment options.

Stone Density

Stone density can influence the expected response to shock wave treatment.

Urinary Obstruction

Obstruction may increase the urgency of treatment.

Infection

An infected obstructed system requires urgent attention.

Kidney Function

Treatment planning becomes particularly important when kidney function is already reduced.

Patient Health

Age, pregnancy, bleeding risk, medications and other medical conditions can influence procedure selection.

What Happens After a Kidney Stone Is Removed?

Stone treatment should not necessarily end with removal.

If possible, the stone or fragments may be analyzed to determine their composition. A doctor may also recommend further evaluation to identify why the stone developed.

Depending on the patient's history, follow-up may include:

• Repeat imaging

• Urine testing

• Blood tests

• Stone analysis

• Metabolic evaluation

• 24-hour urine testing in selected recurrent stone formers

This information can help create a prevention strategy.

How Can You Reduce the Risk of Another Stone?

Kidney stones can recur, so prevention is an important part of long-term care.

Maintain Appropriate Fluid Intake

Adequate fluid helps dilute urine and can reduce the concentration of stone-forming substances. The appropriate amount should be individualized, particularly in people with kidney failure or other fluid restrictions.

Reduce Excess Sodium

A high-sodium diet can increase the risk of some types of kidney stones.

Reducing excessive salt intake may therefore be recommended.

Follow a Stone-Specific Diet

Dietary advice depends on whether the stone is:

• Calcium oxalate

• Calcium phosphate

• Uric acid

• Cystine

• Struvite

Changes may involve sodium, animal protein, oxalate, calcium or other dietary factors depending on the stone type.

Do Not Unnecessarily Eliminate Dietary Calcium

People with calcium stones should not automatically remove calcium-containing foods from their diet.

Dietary advice should be based on the specific stone type and the individual's metabolic evaluation.

Treat Recurrent Infections

Some stones are associated with urinary infections. Appropriate treatment and evaluation of recurrent infections may help reduce complications.

When Is Stone Problem Treatment Urgent?

Seek prompt medical attention if a suspected or known stone causes:

• Fever or chills

• Severe or worsening pain

• Persistent vomiting

• Very little or no urine

• Difficulty passing urine

• Blood in urine with worsening symptoms

• Known urinary obstruction

• Rising creatinine

• Severe weakness or confusion

A stone associated with infection and obstruction is particularly concerning.

Kidney Stone Treatment at Prabhakar Bhurke Clinic

At Prabhakar Bhurke Clinic, Dr. Sandip Prabhakar Bhurke, super specialist nephrologist and transplant physician, provides individualized evaluation for patients with kidney stones and related kidney-function concerns.

Depending on the clinical situation, evaluation may include:

• Review of ultrasound or CT findings

• Kidney-function assessment

• Creatinine and eGFR monitoring

• Urine examination

• Assessment of urinary obstruction

• Evaluation of recurrent urinary infections

• Review of stone history

• Metabolic risk assessment

• Preventive kidney-stone management

• Coordination with an appropriate urologist when a stone-removal procedure is required

• Follow-up after stone treatment

The treatment pathway is selected according to the patient's stone characteristics, kidney function and overall medical condition.

Frequently Asked Questions

What is the best treatment for a stone problem?

There is no single best treatment for every kidney stone. Observation, medicines, ESWL, ureteroscopy with laser treatment and PCNL may all have a role depending on stone size, location, composition, obstruction, infection and symptoms.

Can kidney stones be removed without surgery?

Some small stones can pass naturally, and selected stones may respond to medical treatment. Larger, obstructing or persistent stones may require an active procedure.

Which medicine is used for kidney stones?

Medicine may be prescribed for pain relief, selected stone passage or prevention of future stones. The appropriate medicine depends on the stone type, location, kidney function and other health factors.

Is laser treatment effective for kidney stones?

Laser lithotripsy can fragment stones during ureteroscopy. It is an established treatment option for selected ureteral and kidney stones, although the procedure chosen depends on individual stone characteristics.

When is PCNL needed?

PCNL is generally considered for larger or complex kidney stones when a percutaneous approach is appropriate. The exact indication depends on stone burden, anatomy and the patient's clinical condition.

Can a kidney stone damage the kidney?

A stone can impair kidney function when it causes persistent obstruction, recurrent infection or other complications. Prompt evaluation is particularly important when urine flow is blocked.

Can kidney stones come back after treatment?

Yes. Removing a stone does not necessarily remove the metabolic or dietary factors that caused it. Stone analysis and preventive evaluation can help reduce recurrence risk.

Can I drink a lot of water to flush out a stone?

Adequate hydration may be useful in selected patients, but excessive water does not guarantee passage of a large or obstructing stone. Fluid intake should be individualized.

Conclusion

Stone problem treatment depends on much more than the presence of a stone on an ultrasound or scan. The size, location, composition, obstruction, infection status, kidney function and symptoms all influence the appropriate management strategy.

Some small stones can pass with observation and medical support. Others may require ESWL, ureteroscopy with laser lithotripsy or PCNL to achieve effective removal. When infection occurs behind an obstruction, urgent drainage and medical treatment may be required.

Long-term care is also important. Understanding the stone type, maintaining appropriate hydration, reducing excessive sodium and following individualized dietary or preventive treatment can help lower the risk of recurrence.

For specialist evaluation of kidney stones and related kidney-function concerns, consult Dr. Sandip Prabhakar Bhurke at Prabhakar Bhurke Clinic.

Medical Disclaimer

This article is intended for general educational and informational purposes only and should not be considered a substitute for medical diagnosis, treatment or individualized medical advice. Kidney stone treatment depends on stone size, location, composition, obstruction, infection, kidney function and the patient's overall health. Not every patient is suitable for observation, medicines, ESWL, laser treatment or PCNL. Do not take unprescribed stone medicines, painkillers or herbal remedies, and do not force excessive fluid intake in an attempt to pass a stone. Fever, chills, severe pain, persistent vomiting, very little or no urine, confusion or suspected infection with urinary obstruction requires prompt medical assessment. Consult Dr. Sandip Prabhakar Bhurke or another qualified kidney or urinary stone specialist for an individualized treatment plan.