Treatment of Kidney Stones

If your doctor thinks the stone can pass on its own, and you feel you can deal with the pain, he or she may suggest home treatment, including:

• Drinking more fluids. You need to drink enough water to keep your urine clear, about 8 to 10 glasses a day. Try to drink 2 glasses of water every 2 hours while you are awake. If you have kidney, heart, or liver disease and are on fluid restrictions, talk with your doctor before increasing your fluid intake.
• Not drinking grapefruit juice. Drinking grapefruit juice may increase your risk for developing kidney stones.
• Using pain medicine. Nonprescription medicine, such as nonsteroidal anti-inflammatories (NSAIDs), may relieve your pain. Your doctor can prescribe stronger pain medicine if needed.

Your doctor may prescribe medicine to help your body pass the stone. Calcium channel blockers and alpha-blockers have been shown to help kidney stones pass more quickly with very few side effects. Ask your doctor if one of these medicines can help you.

If your pain is too severe, if the stones are blocking the urinary tract, or if you also have an infection, your doctor will probably suggest medical or surgical treatment. Your options are:

• Extracorporeal shock wave lithotripsy (ESWL). ESWL uses shock waves that pass easily through the body but are strong enough to break up a kidney stone. This is the most commonly used medical treatment for kidney stones. See a picture of ESWL.
• Percutaneous nephrolithotomy or nephrolithotripsy. The surgeon puts a narrow telescope into the kidney through a cut in your back. He or she then removes the stone (lithotomy) or breaks it up and removes it (lithotripsy). This procedure may be used if ESWL does not work or if you have a very large stone.
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• Ureteroscopy.The surgeon passes a very thin telescope tube (ureteroscope) up the urinary tract to the stone's location, where he or she uses instruments to remove the stone or break it up for easier removal. Occasionally, you may need a small hollow tube (ureteral stent) placed in the ureter for a short time to keep it open and drain urine and any stone pieces. Ureteroscopy is often used for stones that have moved from the kidney to the ureter. See a picture of ureteroscopy
• Open surgery. The surgeon makes a cut in the side or the belly to reach the kidneys and remove the stone. This treatment is rarely used.