What it is
Kidney stones are hard lumps that form in the kidney. Many pass out in the urine on their own. When treatment is needed, the main choices are:
- Shockwave : shock waves from outside the body break the stone into pieces small enough to pass
- : a thin telescope passed up the urine tube removes the stone or breaks it up
- PCNL (percutaneous nephrolithotomy): a keyhole operation through the back, for large stones
Why it is done
Treatment is needed when a stone is too big to pass, blocks urine, causes pain that carries on, keeps causing urine infections, or harms the kidney. The choice depends on the size, number and position of the stones, and on your health.
What it helps with
- Kidney stones
Stones in the ureter (the tube from kidney to bladder)
- Urinary tract infection
How to prepare
Do
- Follow the instructions on when to stop eating and drinking
- Tell the team if you might be pregnant, and about every medicine you use
- Ask which medicines to take on the day and which to stop beforehand
- Arrange for someone to take you home
Do not
- Do not stop or change medicines yourself
- Do not keep quiet about a cold, fever or other illness: the treatment may need to be moved
What happens
Shockwave goes like this:
- You are given medicine for pain or relaxation, and sometimes . Some people have a general anaesthetic.
- You lie on a water-filled cushion. X-ray or finds the stone, and shock waves are aimed at it. If you are awake you may feel tapping.
- It takes about 45 minutes to 1 hour. You rest in recovery for up to about 2 hours, and most people go home the same day.
- A (a thin drainage tube) may be placed in the kidney before or after, and you may be given a strainer to catch stone pieces.
is done under general anaesthetic, through the urine tube and bladder. PCNL is done under general anaesthetic while you lie on your front: an instrument goes into the kidney through the back, and a drainage tube and stent may stay in for a while, so you may stay a night or longer.
Afterwards
Have someone drive you home. Blood in the urine is expected for a few days to a few weeks. As pieces pass you may have pain and nausea, sometimes for weeks. Drink plenty of water as advised. You may be given a medicine to help pieces pass and asked to strain your urine. After shockwave treatment most people are back to daily activities in 1 to 2 days.
Call your doctor straight away for:
- Severe back or side pain that will not go
- Heavy bleeding or clots in the urine
- Fever and chills
- Vomiting, or feeling faint with a fast heartbeat
- Foul-smelling urine, burning when you pass urine, or very little urine
Risks and side effects
These treatments are usually safe, but possible problems include:
- Bleeding around the kidney, which may need a blood transfusion
- Kidney infection
- Stone pieces blocking the flow of urine, causing pain or kidney damage
- Pieces left behind, needing more treatment
- Reduced kidney function
- Ulcers in the stomach or small intestine, after shockwave treatment
Shockwave treatment can also leave bruising and soreness on the back or side.
Results and what comes next
Results depend on the number, size and position of the stones. Sometimes pieces are left behind and a second procedure is needed. After PCNL the tubes come out once X-rays show the stones have gone.
You will be asked to come back for a check in the weeks afterwards. The stone may be sent to a lab to find its type. Most people then need to change what they drink or eat to prevent new stones, and some need medicines.
Questions to ask your doctor
Tick the ones you want answered and take them with you.
Common questions
Do all kidney stones need treatment in hospital?
No. Most small stones pass on their own over a few weeks with plenty of fluids, and you may be given medicines for pain, sickness and to help the stone pass. Hospital treatment is for stones that are large, block the flow of urine, cause severe pain or infection, or do not pass.
Does shockwave treatment hurt?
You are given medicine for pain or relaxation, and some people have a general anaesthetic. If you are awake you may feel tapping. Afterwards there can be bruising and soreness on the back or side, and pain as stone pieces pass.
Is blood in the urine after treatment normal?
A small amount of blood in the urine for a few days to a few weeks is expected. Heavy bleeding or clots are not normal, so contact your doctor straight away.
Can kidney stones come back?
New stones can form, which is why most people are advised to change what they drink or eat, and some are given medicines. The team may test the stone and a 24-hour urine collection to find the cause and the best way to prevent more.
