Our kidney stone specialists work with you to create a plan to manage and treat your stones. Patient education is an important part of our program.
Most stones do not require surgery. A variety of factors are considered when deciding if surgery is the best option. Decision making depends on where your stone is located:
Treatments for stones
At the HealthEast Kidney Stone Institute, we offer a complete range of treatment options. If you need surgery, we carefully explain your options - including advantages, disadvantages and success rates. Our specialists will guide you to choose the best treatment for your condition.
Our goal is to provide treatment that is successful in a single procedure, with the least possible discomfort. This helps you get back to your regular activities as quickly as possible.
The Kidney Stone Institute offers these treatments:
Success rates vary by treatment and no treatment for stones works 100 percent of the time.
Every patient wants to know - and absolutely should know - before their procedure, what the chance of success for their situation should be. It’s important to discuss this with your doctor. It’s also important to realize that any time a stone is broken, fragments and dust are generated and there is the possibility that some will be left behind.
Should my kidney stone be removed?
Kidney stones fall into two basic categories — those that are currently causing symptoms and those that have the potential to cause symptoms. Those causing symptoms such as infection or pain require treatment.
Although there's usually no need to treat a stone that's not causing symptoms, we understand that many people do not want the potential for disruption in their lives. Approximately 50 percent of kidney stones that currently aren't causing problems will cause symptoms sometime in the next five years.
"Watchful waiting" means that you currently don't need treatment to remove kidney stones, but your doctor continues to watch the stones to see if they are growing or changing. At the HealthEast Kidney Stone Institute, periodic x-rays or CT scans determine if stones are increasing in size and number. Patients can have stones removed if their condition or priorities change.
Reasons to leave a kidney stone untreated
- Your stone isn't currently causing symptoms
- Your stone is small. Stones less than 5 mm in size are often capable of passing on their own if they fall into the ureter.
- You prefer to avoid treatment
Reasons to treat a kidney stone
- Stone is causing pain or other symptoms
- Chronic or recurrent urinary tract infections
Kidney stones may harbor infections that the body is unable to clear, even with antibiotics. At that point, the only way to clear these infections is by removing the stone.
- Larger stones
Stones greater than 5 mm are unlikely to pass on their own and usually require treatment if they fall into the ureter. This creates an unwanted emergency.
- Staghorn stones
Staghorn stones are large and usually infection related. Because they can grow to huge sizes and fill the kidney, they can pose kidney and health risks if left untreated. The American Urological Association recommends that these stones be treated whenever they are discovered.
- Occupational requirements
For example, FAA regulations require that airline pilots be grounded until the stone is cleared. Even when not required by their occupations, many people do not have schedules that allow unanticipated time away from their work.
- Women of childbearing age
During pregnancy an obstructing stone is often more difficult to diagnose and treat and can pose risks to the mother and unborn child. We recommend that any woman planning pregnancy who has known stones undergo elective stone clearance prior to conception.
- Travel to medically underserved areas
People who frequently travel to areas where medical care is unavailable or unreliable should consider treatment to avoid an incident in less than optimal conditions.
- Patient preference
Many patients simply want their stones removed. We are particularly sensitive to those patients who have taken steps to reduce their risk of stone recurrence but have one or more stones remaining in their kidneys. Many patients opt to schedule treatment when it's convenient for them and select therapies that are most likely to clear the stone in a single treatment.
Should my ureteral stone be removed?
A ureteral stone is a stone that is in the ureter (the narrow duct that drains urine from the kidney to the bladder). Once a stone enters the ureter, it will either pass or it will need to be removed.
Ureteral stones and size
- Large stones generally cause symptoms as soon as they enter the ureter.
- Some larger stones are big enough to have irregular shapes, so they may not completely obstruct the ureter or cause severe symptoms.
- Smaller stones often make their way further down the ureter before they are noticed.
- Small smooth stones are often associated with more severe pain because they are more likely to completely obstruct the ureter.
Stone symptoms occur when a stone gets stuck. Stones are commonly discovered at these three locations:
- The start of the ureter
- Two-thirds of the way down the ureter
- Near the bladder
A single stone may cause symptoms at any or all of these locations. Unfortunately, the severity of pain and number of attacks vary from person to person and aren't good indicators if a stone will pass on its own.
Reasons to leave a ureteral stone untreated
- Smaller stones are more likely to pass
- Stone location - the farther a stone progresses, the better its chances of passing.
- Previous successful stone passage - patients who have successfully passed stones in the past will often do so again.
- Patient who wish to avoid surgical intervention will often tolerate episodes of discomfort.
These factors support pursuing a trial of passage.
What is "trial of passage"?
When a ureteral stone has a reasonable chance of passing by itself, we support the patient through this process. Depending on the size, location and symptoms, follow-up CT scans are performed every one to two weeks. Patients are closely monitored for signs of trouble.
What if I pass the stone?
If the stone passes, it is important to save it and bring it into the clinic. An analysis of the stone's composition may provide important information to help you prevent future stones.
When treatment is required
Treatment is always available if the stone fails to progress down the ureter or begins to cause more severe symptoms. Surgical stone removal is available on a prompt basis when necessary. In general, we allow about one month for a stone to pass if symptoms are tolerable.
Reasons to treat a ureteral stone
- Larger stones are less likely to pass
- Stone location - the farther a stone needs to move, the less likely it is to do so.
- Previous stones that didn't pass - patients who have had trouble in the past, often will again.
- Duration of symptoms - treatment is recommended if a stone hasn't progressed within one month.
- Patient preference - many patients want the stone removed as quickly as possible.
In certain situations it may not be safe to remove stones. This may be the case if a patient has an active kidney infection (treatment could cause illness) or if a patient has other untreated medical problems.
In these circumstances, pain can be relieved by placing either a stent (an internal tube between the kidney and bladder) or a nephrostomy tube (tube inserted into the kidney through the back).
While these procedures can be performed quickly and can relieve pain, they do not do anything to treat the stone. In emergency situations, the procedures create time and allow treatment to be performed safely.
Contact Kidney Stone InstituteA doctor's referral is not required to make an appointment.
Monday through Friday, 8 am to 4:30 pm
Outside of these hours, you can call us and speak with a registered nurse who will review your symptoms and make recommendations to help you get appropriate care.