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Treatments and drugs
By Mayo Clinic staffTreatment for kidney stones varies, depending on the type of stone and the cause. You may be able to move a stone through your urinary tract simply by drinking plenty of water — as much as 2 to 3 quarts (1.9 to 2.8 liters) a day — and by staying physically active.
Stones that can't be treated with more-conservative measures — either because they're too large to pass on their own or because they cause bleeding, kidney damage or ongoing urinary tract infections — may need professional treatment. Procedures include:
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Extracorporeal shock wave lithotripsy (ESWL). This is a commonly used procedure for treating kidney stones. It uses shock waves to break the stones into tiny pieces that are then passed in your urine. In some cases, you may be partially submerged in a tub of water during the procedure. In others, you may lie on a soft cushion. You'll generally require sedation or light anesthesia due to moderate pain caused by the shock waves. A loud noise is produced each time a shock wave is generated, and you'll wear earphones to protect your hearing.
Your doctor will likely use X-rays or ultrasound to help determine the position of the stone as well as to monitor the status of the stone during treatment.
Complications that may occur with ESWL include blood in the urine, bruising on the back or abdomen, bleeding around the kidney and other adjacent organs, and discomfort as the stone fragments pass through the urinary tract. In addition, if the stone doesn't shatter completely, you may need a second round of ESWL or ureteroscopic stone removal. After treatment, it may take months for all the stone fragments to pass.
- Percutaneous nephrolithotomy. When ESWL isn't effective, or the stone is very large, your surgeon may remove your kidney stone through a small incision in your back using an instrument called a nephroscope.
- Ureteroscopic stone removal. This procedure may be used to remove a stone lodged in a ureter. The stone is snared with a small instrument (ureteroscope) that's passed into the ureter through your bladder. Ultrasound or laser energy also can be directed through the scope to shatter the stone. These methods work especially well on stones in the lower part of the ureter.
- Parathyroid surgery. Some calcium stones are caused by overactive parathyroid glands, which are located on the four corners of your thyroid gland, just below your Adam's apple. When these glands produce too much parathyroid hormone, your body's level of calcium can become too high, resulting in excessive excretion of calcium in your urine. Most often, this is the result of a small benign tumor in one of your four parathyroid glands. A doctor can surgically remove the tumor.
