28 February 2019
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Treatment for kidney stones involves various procedures that help you get rid of these stone-like lumps that can form in your urine, become painful and - if untreated - damage your kidneys.
The size of your kidney stones will determine which procedure you have, but the most common form is a straightforward operation called a lithotripsy. This uses high-energy sound waves to break the stones down into tiny fragments, which are then flushed out of the body in the urine.
Kidney stones are quite common. They affect men more than women, generally in people aged 30 to 60. About 10-20% of men affected by them experience severe pain while 3-5% of women affected have severe pain. (source: NHS Choices)
According to the British Association of Urological Surgeons, stones are responsible for more than 12,000 hospital admissions each year.
These stones are formed from crystals found in the urine and in most cases they are too small to be noticed and pass harmlessly out of the body. However, sometimes they can build up inside your kidney and form much larger stones, which can be big enough to block the flow of urine, causing pressure, pain, infection and even permanent damage to your kidney function.
A procedure known as extracorporeal shock wave lithotripsy (ESWL) is the most common approach. It is a safe and relatively simple treatment that is carried out as an out-patient or day case, without the need for anaesthesia. It uses high-energy sound waves to break the stones down into tiny fragments that are then flushed out of the body in the urine.
The benefits of having this non-surgical treatment are, for most people, much greater than the risks, which are minimal.
For larger stones, there are other surgical procedures such as laser stone surgery, during which your surgeon passes a long thin telescope into your bladder to extract or break down the stones. This is performed using a general anaesthetic so you are asleep throughout the procedure.
Our consultants will explain all the medical issues and discuss which treatment is best for you.
If you decide to have your treatment with us, you will be looked after by an experienced multi-disciplinary care team.
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Our consultants have high standards to meet, often holding specialist NHS posts and delivering expertise in complex sub-specialty surgeries. Many of our consultants have international reputations for their research in their specialised field.
You will have a formal consultation with a healthcare professional. During this time you will be able to explain your medical history, symptoms and raise any concerns that you might have.
We will also discuss with you whether any further diagnostic tests, such as scans or blood tests, are needed. Any additional costs will be discussed before further tests are carried out.
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For more information on visiting hours, our food, what to pack if you're staying with us, parking and all those other important practicalities, please visit our patient information pages.
Our dedicated team will also give you tailored advice to follow in the run up to your visit.
We understand that having surgery can often be a time of anxiety and worry, but our experienced and caring medical staff will be there for you, holding your hand, every step of the way.
You may have one of the following procedures:
If you are having a lithotripsy procedure, you will lie on your back on the couch and an X-ray or ultrasound will be used to pinpoint the exact position of the kidney stone. Once located, some gel will be smeared on your skin to enable good contact with the lithotripter probe. The probe will focus the sound waves precisely on to the stone to break it up. Try to relax and avoid moving during the treatment.
The sound waves themselves do not hurt, but you may feel an unusual and uncomfortable sensation as the stone is broken up. You will be given pain relief to make the procedure more comfortable. The treatment usually takes up to 30 minutes and if you have several stones in the same kidney they may all be treated, but only one kidney is treated at a time. Your consultant will explain the benefits and risks of having lithotripsy, and will discuss any alternatives.
This is for those stones that are too large or hard to be treated with lithotripsy. It involves a day case procedure during which the surgeon passes very thin flexible instruments up to the stone in the kidney, and breaks it up using laser energy. The fragments are then removed during the operation rather than leaving them to drain naturally.
This is used when a stone becomes lodged in the pipe draining the kidney, which can cause very severe pain and - if not treated quickly - kidney damage.
This is used for very large stones - over 2cm. It involves passing stone-breaking instruments into the kidney through a small incision in your back. You will need to stay in hospital for a night or two afterwards.
All of these treatments are performed under general anaesthetic so you will be asleep throughout the procedure.
After the procedure, you will be taken from the operating theatre to a recovery room, where you will come round from the anaesthesia under close supervision.
After this, you will be taken to your room or comfortable area where you can rest and recuperate until we feel you're ready to go home.
Lithotripsy is normally performed as a day case so you will be able to go home the same day. If you have had a more serious form of treatment, you may have to stay in hospital for a couple of days. You should drink fluids regularly for 48 hours after your treatment to help flush your kidneys and lower the risk of developing a urinary tract infection.
Before you go home, a nurse will make arrangements for you to have a further X-ray and a follow-up appointment at the out-patient clinic.
Once you have undergone a lithotripsy treatment, you may have some discomfort and you will be given painkillers to relieve this.
After lithotripsy, stone fragments may pass in your urine for a few weeks and cause you some pain. It's normal to see small fragments of the broken stone and a little blood in your urine during the first few days.
Your consultant will advise you how soon you can go back to work and how long you should wait before resuming regular physical activities.
We will provide you with a supply of all the medicines your consultant feels you need to take home with you after you've left hospital, up to 14 days. This may be at an additional cost to some patients.
It's sensible to take it easy for the rest of the day and if possible arrange to have the following day off work.
To prevent kidney stones from developing again, you should drink plenty of water daily to stop becoming dehydrated, and look at what you eat to make sure you have a normal-calcium, low-salt, low-protein diet. (source: British Association of Urological Surgeons)
The success of your treatment will depend on the density, size and position of the stone. Some lithotripsies are not successfully completed on a single visit and may need to be repeated.
Once you're ready to be discharged, you'll need to arrange a taxi, friend or family member to take you home as you won't be able to drive. You should also ask them if they can run some light errands such as shopping for you as you won't be feeling up to it.
Even once you've left hospital, we're still here for you. Your consultant is likely to want to see you again to check how you're doing. A follow-up appointment at the out-patient clinic will be made for you before you leave the hospital.
On rare occasions, complications following kidney stones treatment can occur. If you experience any of these symptoms - feel unwell or have severe pain, develop a high temperature, feel a burning sensation on passing urine or if your urine becomes smelly, have an increase in blood in the urine - please call us straight away. Specific complications of lithotripsy are rare but you may develop a urinary tract infection, which will need to be treated with antibiotics that we will supply.
We will talk to you about the possible risks and complications of having this procedure and how they apply to you.
If you have any questions or concerns, we're ready to help.
We are committed to delivering excellent individual care and customer service across our network of hospitals, clinics and specialist care centres around the UK. Our dedicated and highly trained team aim to achieve consistently excellent results. For us it's more than just treating patients, it's about looking after people.
The treatment described on this page may be adapted to meet your individual needs, so it's important to follow your healthcare professional's advice and raise any questions that you may have with them.
28 February 2019
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