If you have a kidney stone, the type of treatment that you will need will depend on the type of kidney stone that you have.
Small kidney stones
Most kidney stones will be small enough to be passed in your urine, and it may be possible to treat these at home. For stones up to 4mm (0.2in) in diameter, eight out of ten people will be able to pass them in their urine.
However, small kidney stones may still cause pain. The pain from smaller kidney stones usually lasts a couple of days and disappears when the stone has been passed.
If you have severe pain, your GP may inject you with a painkiller. A second dose can be given after half an hour if you are still experiencing pain.
Medication can also be injected to treat the symptoms of nausea (feeling sick) and vomiting. This is called an anti-emetic (anti-sickness) medication.
You may also be given a prescription for painkillers, anti-emetics or both, to take at home.
If you are sent home to wait for your kidney stone to pass, you may be advised to try to collect the stone from your urine. You can do this by filtering your urine through gauze or a stocking. The stone can be given to your GP to help them determine any further treatment you may need.
You should drink enough water to make your urine colourless. If your urine is yellow or brown you are not drinking enough.
See the box to the right for advice about when to seek urgent medical attention if you are treating your kidney stones at home.
Large kidney stones
If a kidney stone is too big to be passed naturally, you may need to have treatment to remove it another way. If your stone is 6-7mm (0.3in) in diameter, or larger, you may require treatment. This could include:
- extracorporeal shock wave lithotripsy (ESWL)
- percutaneous nephrolithotomy (PCNL)
These procedures are explained in more detail below. The type of treatment you have will depend on the size and location of your stones.
Extracorporeal shock wave lithotripsy (ESWL)
Extracorporeal shock wave lithotripsy (ESWL) is the most common way of treating kidney stones that cannot be passed in the urine.
ESWL involves using X-rays (high-energy radiation) or ultrasound (high-frequency sound waves) to pin-point where a kidney stone is. A machine then sends shock waves of energy to the stone to break it into smaller pieces so it can be passed in your urine.
ESWL can be an uncomfortable form of treatment, so it is usually performed under a local anaesthetic (painkilling medication).
You may need more than one session of ESWL in order to treat your kidney stones successfully. For stones that are up to 20mm (0.8in) in diameter, ESWL is up to 99% effective.
Percutaneous nephrolithotomy (PCNL)
Percutaneous nephrolithotomy (PCNL) is an alternative procedure that may be used for larger stones. It may also be used if ESWL is not suitable, for example, because the person being treated is obese.
PCNL involves using a thin telescopic instrument that is called a nephroscope. An incision (cut) that leads to your kidney is made in your back. The nephroscope is passed through the incision and into your kidney. The stone is either pulled out, or broken into smaller pieces using a laser or ESWL.
PCNL is often performed under general anaesthetic, which means that you should not drive or operate machinery for up to 48 hours after the procedure.
As PCNL is a type of surgical procedure, it does carry more risks than ESWL. For stones that are 21-30mm (0.8-1.2in) in diameter, PCNL is 86% effective.
If a kidney stone is stuck in your ureter (the muscular tube that carries waste products from your kidneys to your bladder), you may need to have ureterorenoscopy. Ureterorenoscopy is also sometimes known as retrograde intrarenal surgery (RIRS).
Ureterorenoscopy involves passing a long, thin telescope, called a ureteroscope, through your urethra (the tube that carries urine from the bladder to the outside of the body), into your bladder. It is then passed up into your ureter to where the stone is stuck.
The surgeon may either try gently to remove the stone using another instrument, or they may use lasers, or ESWL, to break the stone up into small pieces so that it can be passed naturally in your urine.
As with PCNL, ureterorenoscopy is also performed under general anaesthetic, so you should not drive or operate machinery for up to 48 hours after the procedure.
For stones up to 15mm (0.6in), an ureterorenoscopy is effective in 50-80% of cases.
If none of the methods for removing your kidney stone that are described above are suitable, it may be necessary to remove it using traditional surgery. This will involve making an incision (cut) in your back in order to gain access to both your ureter and your kidney. The kidney stone can then be removed.
This kind of surgery is only necessary in around 5% of cases.
Uric acid stones
If you have a uric acid stone, you may be advised to drink around three litres of water each day to try to dissolve it. Uric acid stones are much softer than other types of kidney stone, and they can be made smaller if they are exposed to alkaline fluids.
You may need to take some medication to make your urine more alkaline before the uric acid stone starts to dissolve.