How are kidney stones treated?

Once diagnosed, your healthcare provider will first determine if you even need treatment. Some smaller kidney stones may leave your system when you urinate. This can be very painful. If your provider decides that you do need treatment, your options include medications and surgery.

Medications. Medications may be prescribed to:

• Decrease pain. Your healthcare provider may recommend that you take an over-the-counter medication like ibuprofen or if you’re in the emergency room, an IV narcotic.
• Manage nausea/vomiting.
• Relax your ureter so that the stones pass. Commonly prescribed medicines include tamsulosin (Flomax®) and nifedipine (Adamant® or Procardia®).

You should ask your healthcare provider before you take ibuprofen. This drug can increase the risk of kidney failure if taken while you’re having an acute attack of kidney stones — especially in those who have a history of kidney disease and associated illnesses such as diabetes, hypertension, and obesity.

Surgery. There are four types of surgeries used to treat kidney stones. The first three are minimally invasive, meaning that the surgeon enters your body through a natural opening (like your urethra), or makes a small incision.

• Ureteroscopy: To perform this procedure, a small instrument called a ureteroscope is inserted in your urethra, through your bladder, and into a ureter. This instrument shows the kidney stones and then retrieves them in a surgical “basket,” or breaks them apart using a laser. These smaller pieces of kidney stones are then easily able to exit your body through your urinary tract.

• Shockwave lithotripsy: In this procedure, you’re placed on a special type of surgical table or tub. High-energy shockwaves are sent through the water to the stone(s). The shockwaves break apart the stones, which are then more easily able to exit your body.

• Percutaneous nephrolithotomy: When kidney stones can’t be treated by the other procedures — either because there are too many stones, the stones are too large or heavy or because of their location — percutaneous nephrolithotomy is considered. In this procedure, a tube is inserted directly into your kidney through a small incision in your back. Stones are then disintegrated by an ultrasound probe and suctioned out so that you don’t have to pass any fragments. A urethral stent is placed after the procedure (an internal tube from the kidney to the bladder which is removed one week later). Patients are typically kept overnight for observation.

• Open stone surgery: A longer cut is used during this surgery. Compared to minimally invasive procedures, it’s rarely performed (0.3% to 0.7% of cases).