Pass Kidney Stones

After a computed tomography (CT) scan, ultrasound, intravenous pyelography (IVP), or X-ray reveals the presence of a kidney stone, the doctor must decide how to treat the patient according to the size, shape, location, formation, and medical risk of the stone.

Most Simple Kidney Stones Pass By Urination In 2-3 Days

About 85% of kidney stones — five millimeters or less in size — pass naturally through the urinary tract in two to three days. Although, some stone can take weeks, months, and even a year or more to pass from the body.

If there is a high likelihood the stone will pass by itself, the doctor will ask the patient to drink at least two to three quarts of water per day to dilute the urine, decrease crystal formations, and move the stone through the urinary tract. The patient typically urinates into a strainer to “catch” the stone so it can be analyzed for composition and used to prescribe appropriate preventative measures in the future.

For pain and inflammation, a doctor will recommend over-the-counter pain medications like ibuprofen or prescribe stronger opioids or nonsteroidal anti-inflammatory drugs (NSAIDs). In some cases, a kidney stone sufferer may require other medications (like calcium channel blockers and alpha-blockers) to assist in the passing of the kidney stone.

Medical And Surgical Treatments

If the kidney stone is larger than five millimeters; irregularly shaped; or there is urinary blockage, infection, or potential damage to the kidneys, bladder, or urinary tract, then medical or surgical treatment may be required to dissolve or remove the stone.

• Extracorporeal Shock Wave Lithotripsy (EWSL) — Extracorporeal shock wave lithotripsy (ESWL) uses shock waves to shatter kidney stones (one inch or less in diameter) into sand-like particles that can easily and painlessly pass out of the body through the urinary tract. ESWL is the most common non-invasive medical treatment for simple kidney stones. Usually, urologists give local or general anesthesia before the procedure. To receive ESWL, the patient lies in a water bath or on a cushion as a machine called a Lithotripter produces hundreds of shock waves that travel through the localized body tissue to pulverize the kidney stone into tiny pieces. Sometimes, patients must receive several ESWL procedures before their stones become small enough particles to easily pass through the body. Generally, ESWL is an outpatient procedure and most patients are discharged after a few hours. Recovery time typically lasts only a few days. Common side effects include blood in the urine for a few days after the procedure (transient hematuria) and bruising on the back due to the shock waves. Some researchers suggest that ESWL can increase the risk of more serious conditions like diabetes and hypertension (high blood pressure).

• Percutaneous Nephrolithotomy — When ESWL fails to work or the kidney stone is larger than one inch in diameter, then the urologist may remove the stone with percutaneous nephrolithotomy. After the patient receives general anesthesia, the urologist makes a small incision in the back and inserts a nephroscope into the kidney. Depending on the size of the stone, the urologist can either remove the stone directly or use ultrasound, compressed air, or a laser to crush the stone and then remove the tiny particles. Percutaneous nephrolithotomy typically requires a hospital stay of two to three days and recovery time can take a few weeks. Side effects include tissue scarring because of the incision, pain and discomfort, and a risk of blood loss before and after the procedure.

• Ureteroscopy — Ureteroscopy is a procedure used to remove kidney stones stuck in the ureter (the tube that connects the kidneys to the bladder). To perform a ureteroscopy, the urologist inserts an instrument called a ureteroscope through the patient’s urethra (the tube that connects the bladder to the outside of the body) and bladder into the ureter. If the urologist can’t remove the stone directly, ultrasound, compressed air, or a laser may be used to break the stone into smaller particles for easier removal. Common side effects include pain, discomfort, and blockage of the urinary tract due to large and jagged stone fragments that were not removed during the procedure.

• Open Surgery (Nephrolithotomy) — When a kidney stone becomes too large, irregularly shaped, causes uncontrollable bleeding, or poses a dangerous risk to the kidneys, a urologist may choose to perform open surgery (nephrolithotomy) to remove the stone. In nephrolithotomy, an incision is made through the patient’s side (between the last rib and the hip) and the kidney to directly remove the stone. The urologist must take great caution to isolate arteries in the kidneys from the surgical region to avoid severe bleeding. After the stone is removed, a catheter is inserted into the kidney to drain urine and give the kidney an opportunity to heal. Nephrolithotomy is major surgery, so a patient’s stay in the hospital can last a few days to over a week. Usually, most people who receive open surgery will require a month or more of recovery before they can resume normal activities.