Kidney Stone Treatment

Question: I had a physical recently that showed microscopic blood in my urine. My doctor did an x-ray that showed a kidney stone about 10 millimeters in size. I have mild pain every few weeks, but it doesn’t bother me otherwise. Do I need this treated? Will I need surgery like my dad had years ago for his stone?

Answer: The decision to treat kidney stones should be individualized between the patient and urologist. Stones should always be treated if causing severe kidney blockage, constant or repeated pain attacks, infection or significant bleeding.

When stones are not harming you, then it is not so straight-forward.

Tiny one to two millimeter kidney stones usually don’t need treatment if they are not causing pain, visible bleeding or infection. They usually stay silent or pass with little problem.

Large stones like this, however, are another matter. The fact that you have pain suggests it is moving around, blocking the kidney periodically.

Recent studies show that over a 5-year period there is a 50-50 chance of a stone causing severe kidney blockage or pain – usually without warning and not always at convenient times or places. Furthermore, stones more than 6 to 7 millimeters size have almost no chance of passing on their own. Therefore, I recommend that you have it treated.

Before 1985, all stones required surgery through an incision.

Currently, 98 percent are treated with external shock wave blasting (lithotripsy) or by ureteroscopy, a scope procedure using laser to fragment the stone if in the ureter tube. These incisionless procedures are same-day, under anesthesia, with minimal recovery time. They are 90 percent effective with one treatment. Ten percent may need a second treatment, but most not.

Only 1 in 300 patients now need a large incision, and 1 in 40 a scope surgery through a half-inch incision. Stone treatment is a lot easier today!