The right way to remove a kidney stone depends mainly on its size, location, composition, symptoms and whether it is blocking urine flow.
Some small stones can leave the body naturally without a procedure. Larger stones, stones causing persistent pain or obstruction, and stones associated with complications may require active removal. Treatment options include observation, medicines in selected cases, shock wave lithotripsy, ureteroscopy with laser treatment and percutaneous nephrolithotomy (PCNL).
Therefore, there is no single kidney stone removal method that is suitable for every patient.
At Prabhakar Bhurke Clinic, Dr. Sandip Prabhakar Bhurke, super specialist nephrologist and transplant physician, provides kidney evaluation and helps assess kidney function and complications associated with urinary stones. When a procedure is required, appropriate urological care may be coordinated.
Can a Kidney Stone Come Out on Its Own?
Yes, some smaller kidney stones can pass naturally.
The possibility of spontaneous passage depends on factors such as:
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Stone size
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Stone location
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Shape
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Urinary tract anatomy
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Degree of obstruction
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Symptoms
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Presence or absence of infection
A small stone that has entered the ureter may eventually pass into the bladder and then leave through urine.
However, a larger stone may become stuck and block urine flow.
Waiting for spontaneous passage should therefore be based on medical assessment rather than simply assuming that every stone will pass.
What Is the First Step Before Kidney Stone Removal?
Before deciding how to remove a stone, the doctor needs to understand what is actually present.
Evaluation may include:
Ultrasound
Ultrasound can help identify many stones and may show swelling of the kidney or urinary obstruction.
CT Scan
A non-contrast CT scan can provide detailed information about stone:
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Size
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Location
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Number
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Density
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Urinary obstruction
Urine Testing
Urinalysis may detect blood, infection and other abnormalities.
Blood Tests
Depending on the situation, testing may include:
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Creatinine
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eGFR
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Electrolytes
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Blood count
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Other relevant tests
These investigations help determine whether the stone can be monitored or requires active treatment.
How to Remove a Small Kidney Stone
For a small, uncomplicated stone, the doctor may recommend observation for a period of time.
Management can include:
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Appropriate pain control
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Monitoring symptoms
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Adequate fluid intake when medically appropriate
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Follow-up imaging
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Selected medicines to facilitate passage in appropriate ureteral stones
Not every patient should simply drink large amounts of water. People with kidney failure, significant obstruction or other medical conditions may require individualized fluid advice.
NIDDK notes that small stones may pass without treatment, while larger or obstructing stones may require more active intervention.
Can Medicine Remove a Kidney Stone?
Medicine generally does not dissolve most common kidney stones.
However, medicines may have different roles depending on the situation.
Pain Medicines
Pain-relieving medicines may be prescribed while a stone is passing or while definitive treatment is being planned.
The appropriate medicine depends on kidney function and other medical conditions.
Medicines to Facilitate Stone Passage
In selected patients with certain ureteral stones, doctors may prescribe medicines intended to relax the ureter and improve the chance of passage.
These medicines are not appropriate for every stone and should only be used after medical assessment.
Stone-Specific Medicines
Some types of stones may be managed or prevented with medicines directed at their underlying metabolic cause.
For example, selected uric acid stones may be amenable to medically supervised urine alkalinization.
The stone type should be established before attempting any dissolution treatment.
Can Drinking Water Remove a Kidney Stone?
Adequate fluid intake can support urine production and may help small stones pass when appropriate.
However, drinking excessive quantities of water does not guarantee kidney stone removal.
If a stone is physically blocking the ureter, forcing large amounts of fluid into the urinary system will not necessarily push the stone through and may worsen discomfort.
People with advanced kidney disease, heart conditions or prescribed fluid restrictions should follow their healthcare professional's fluid plan.
For kidney stone prevention, adequate fluid intake is an important general measure, but the appropriate amount varies between individuals.
When Is Kidney Stone Surgery Needed?
Active stone removal may be considered when:
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The stone is unlikely to pass naturally
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Pain remains difficult to control
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Urine flow is obstructed
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Kidney function is being affected
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The stone is growing
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Recurrent infection is associated with the stone
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The stone is large
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The patient has ongoing symptoms
A doctor chooses the procedure according to the stone's characteristics and the patient's health.
Kidney Stone Removal With ESWL
Extracorporeal shock wave lithotripsy (ESWL or SWL) uses shock waves generated outside the body to fragment a kidney stone.
The resulting smaller fragments may then pass through the urinary tract.
ESWL can be suitable for selected stones, but its effectiveness depends on factors such as:
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Stone size
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Location
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Stone composition or density
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Body habitus
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Kidney anatomy
Some patients may need more than one treatment session.
Because ESWL is not appropriate for every stone, imaging and specialist assessment are important before choosing it.
How Is a Kidney Stone Removed With Laser Treatment?
Another common approach is ureteroscopy with laser lithotripsy.
During ureteroscopy:
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A thin scope is introduced through the natural urinary passage.
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The ureter and kidney are examined.
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The stone is located.
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Laser energy is used to fragment the stone.
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Stone fragments may be removed with a small basket or left to pass when appropriate.
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A temporary ureteral stent may be placed in selected cases.
This technique can be useful for stones in the ureter or kidney, depending on their size and location.
NIDDK describes ureteroscopy as a procedure in which stones can be removed or broken into smaller pieces after the ureteroscope reaches the stone.
What Is PCNL and When Is It Used?
Percutaneous nephrolithotomy (PCNL) is a procedure designed to remove larger kidney stones.
Instead of reaching the stone through the urinary passage, the doctor creates a small access tract through the back into the kidney.
A nephroscope is used to locate and remove the stone, and larger stones can be fragmented during the procedure.
PCNL is particularly useful for larger or complex renal stone burdens.
The choice depends on the stone size, location, anatomy, infection status and patient's medical condition.
Can a Large Kidney Stone Be Removed Without Surgery?
Large stones are much less likely to pass naturally.
Depending on their characteristics, some may be treated with ESWL or endoscopic procedures, while larger or complex stones may require PCNL.
Therefore, “without surgery” does not always mean that a medicine or home remedy can remove the stone.
A procedure may be the safest way to clear a stone that is too large to pass or is causing obstruction.
What If the Kidney Stone Is Blocking Urine?
A blocked urinary tract requires timely medical assessment.
Obstruction can interfere with drainage from the kidney and may cause:
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Severe flank pain
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Hydronephrosis
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Reduced urine output
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Kidney-function deterioration
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Infection
If obstruction occurs together with infection, the situation can become an emergency.
In selected cases, doctors may first restore urine drainage with a ureteral stent or nephrostomy before definitive stone removal. A nephrostomy provides drainage directly from the kidney, while a ureteral stent helps urine flow from the kidney to the bladder.
Kidney Stone With Fever: Do Not Delay Treatment
A kidney stone accompanied by:
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Fever
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Chills
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Severe weakness
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Vomiting
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Reduced urine
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Severe flank pain
requires prompt medical assessment.
An infected obstructed urinary tract can become serious and may require urgent drainage and treatment of the infection before definitive stone removal.
Do not attempt to manage this situation at home by drinking excessive water.
How Long Does Kidney Stone Removal Take?
The duration depends on the selected procedure.
Small stones that pass naturally may require monitoring over days or weeks.
ESWL may be performed as an outpatient procedure, although some stones require repeat sessions.
Ureteroscopy is generally performed under anesthesia and many patients can return home the same day, depending on the procedure and clinical condition.
PCNL is generally more involved and may require hospital observation or a short stay.
The treating specialist will explain the expected recovery period.
Is a Stent Needed After Kidney Stone Removal?
A ureteral stent may be placed after some stone procedures.
It can help:
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Maintain urine drainage
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Allow the ureter to recover
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Facilitate passage of fragments
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Reduce the risk of obstruction after selected procedures
Not every patient requires a stent.
When one is used, the doctor should provide clear instructions regarding its planned removal or exchange.
What Happens After a Kidney Stone Is Removed?
Stone removal is only one part of long-term kidney stone care.
The removed stone or fragments may be sent for stone analysis.
In patients at higher risk of recurrence, doctors may recommend additional metabolic evaluation, sometimes including a 24-hour urine collection. This can identify abnormalities that increase the likelihood of forming another stone.
Depending on the results, prevention may involve:
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Appropriate fluid intake
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Lower dietary sodium
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Individualized dietary changes
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Management of specific metabolic abnormalities
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Preventive medicines when indicated
Can Kidney Stones Come Back After Removal?
Yes.
Removing a stone does not necessarily remove the tendency to form stones.
Recurrence can be influenced by:
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Low urine volume
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High sodium intake
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Certain dietary patterns
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Metabolic abnormalities
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Family history
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Recurrent urinary infections
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Specific medical conditions
Understanding the stone type can help guide preventive treatment.
How Can You Reduce the Chance of Another Kidney Stone?
General prevention strategies may include:
Drink an Appropriate Amount of Fluid
Adequate fluid intake helps dilute urine and can reduce the concentration of stone-forming substances. The target should be individualized, especially in people with kidney or heart disease.
Reduce Excess Sodium
High sodium intake can increase urinary calcium in susceptible people and may contribute to calcium stone formation.
Follow an Individualized Diet
The right diet depends on whether the stone is calcium-based, uric acid, struvite, cystine or another type.
Take Prescribed Preventive Medicines
Some recurrent stone formers may benefit from medications selected according to their stone type and metabolic evaluation.
When Should You Seek Emergency Medical Care?
Do not wait for a routine appointment if a suspected kidney stone is accompanied by:
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Fever or chills
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Severe or worsening pain
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Persistent vomiting
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Very little or no urine
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Severe weakness
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Confusion
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Significant bleeding in urine
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Known obstruction with worsening symptoms
A stone that blocks urine flow and is associated with infection requires urgent medical attention.
Kidney Stone Evaluation at Prabhakar Bhurke Clinic
At Prabhakar Bhurke Clinic, Dr. Sandip Prabhakar Bhurke, super specialist nephrologist and transplant physician, provides individualized evaluation of patients with kidney stones and associated kidney-function concerns.
Depending on the patient's condition, evaluation may include:
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Review of ultrasound or CT findings
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Assessment of stone size and location
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Kidney-function testing
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Evaluation for urinary obstruction
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Urine testing
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Infection assessment
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Review of previous stone episodes
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Assessment of recurrent stone risk
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Monitoring of kidney function
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Coordination with appropriate urological specialists when stone removal is required
The appropriate treatment is selected according to the stone characteristics, urinary drainage, infection status and overall health.
Frequently Asked Questions
How can I remove a kidney stone quickly?
The fastest appropriate method depends on the stone. A small stone may pass naturally, while a larger or obstructing stone may require ESWL, ureteroscopy with laser treatment or PCNL.
Can I remove a kidney stone at home?
Some small uncomplicated stones can pass naturally with appropriate medical guidance. Large, obstructing, infected or severely painful stones should not be treated with home remedies alone.
What is the best medicine to remove kidney stones?
There is no single medicine that removes every kidney stone. Medicines may control pain, facilitate passage of selected ureteral stones or treat specific stone-forming conditions.
Does drinking lots of water remove kidney stones?
Adequate hydration can support passage of some small stones, but excessive water does not guarantee removal and can be unsafe for people with certain kidney or heart conditions.
Is laser treatment effective for kidney stones?
Laser lithotripsy performed during ureteroscopy can fragment and remove selected kidney stones. The appropriate procedure depends on stone size, location and other factors.
When is PCNL used for kidney stones?
PCNL is commonly used for larger or complex kidney stones. Suitability depends on stone characteristics, anatomy, infection status and the patient's overall health.
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 can help reduce the risk of complications.
Conclusion
Knowing how to remove a kidney stone starts with determining whether the stone is likely to pass naturally or requires active treatment.
Small uncomplicated stones may pass without a procedure, while stones that are large, obstructing, persistently painful or associated with complications may require ESWL, ureteroscopy with laser lithotripsy or PCNL.
The safest treatment depends on the stone's size, location, composition, urinary drainage and the patient's kidney function and overall health.
A feverish or severely unwell patient with a blocked urinary tract should receive urgent medical attention rather than attempting home treatment.
For individualized kidney evaluation and management of kidney-stone-related kidney problems, 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 the stone's size, location, composition, degree of obstruction, infection status, kidney function and overall health. Do not attempt to force a stone out by drinking excessive amounts of water or by taking unprescribed medicines, herbal remedies or supplements. Pain medicines and medicines intended to facilitate stone passage may not be suitable for everyone, particularly people with kidney disease or other medical conditions. Fever, chills, severe or worsening pain, persistent vomiting, very little or no urine, confusion or rapid deterioration may indicate a serious complication requiring urgent medical attention. Consult Dr. Sandip Prabhakar Bhurke or an appropriate qualified urinary stone specialist for an individualized treatment plan.
