What Is the Treatment for Passing Kidney Stones?
Kidney stone pain control and treatment. The treatment for the renal colic of a kidney stone includes pain control and hydration. For severe pain, some patients go to the emergency department and often receive intravenous (IV) medications including
- narcotics,
- anti-inflammatory medications, and
- medications to control vomiting.
Once the pain is under control in the emergency department, the patient may be discharged home with pain medications and the recommendation to take ibuprofen (Advil) as an anti-inflammatory.
Tamsulosin (Flomax) is a medication often prescribed to help promote stone passage.
No treatment. Kidney stones may be allowed to pass on its own and it may take 2 to 3 weeks or longer. However, there are certain situations where more urgent action may be required.
Solitary kidney stones in patients with a solitary kidney, a kidney stone causing obstruction may lead to kidney failure and emergent referral to a urologist may be required to remove the stone or place a stent to bypass it.
Obstructing kidney stones who develop urinary tract infections or impaired kidney function may need to have a stent or nephrostomy placed to prevent progression of the infection or worsening of the kidney function. Urine that is infected that cannot drain will act like an abscess and can cause the patient to become quite ill, often with fevers and chills.
Large kidney stones that are located in the kidney or the upper ureter may be unable to be passed spontaneously. Lithotripsy, sometimes called extracorporeal shockwave lithotripsy (ESWL) uses ultrasound to deliver energy to break up the large stone into smaller stones and debris that then can be passed or captured by ureteroscopy.
Patients with a large stone that fills the whole kidney (staghorn calculi) may require removal using a special instrument inserted through an incision in the skin directly into the kidney (percutaneous nephrolithotomy).
Can Kidney Stones Pass Naturally without Treatment?
Most kidney stones pass on their own. However, the recurrence rate is high and half the patients can expect to pass another stone within 10 years. For that reason, it is best to find out the type of stone to minimize the risk of future recurrences. Capturing the stone is the first step to find out the type. The stone can then be analyzed in the laboratory. Based upon the type of stone, further metabolic testing may be helpful.
In otherwise healthy patients, the major complication of a kidney stone is the potential for infection or the inability to control pain or nausea.
Can Kidney Stones be Prevented?
By doing nothing more than keeping well hydrated and drinking adequate amounts of water, most kidney stones can be prevented. For those patients who develop kidney stones because of underlying medical conditions, the addition of diet modification or chronic medication may be helpful. It is also essential to hydrate to increase the amount of urine produced to prevent any beginning of a stone.
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