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Kidney stones
















What are kidney stones?

The kidneys have the function of filtering the blood, and in doing so produce urine that contains waste chemicals. These chemicals are usually dissolved in the urine but can sometimes form small crystals; these can clump together and grow in the kidney, forming a stone.

Kidney stone pain


Stones are similar to small pieces of sand or gravel, and may cause no symptoms at all, or may simply be passed out with the urine. Occasionally the stone becomes lodged in the kidney or in the tube that connects the kidney to the bladder (the ureter), where it can cause symptoms.



What symptoms can kidney stones cause?

  • Pain - a stone that is lodged in the kidney or ureter often causes pain in the side of the abdomen or in the lower abdomen and groin. The pain tends to come and go in waves, and is very severe in nature.

  • Bleeding - as the stone rubs against the ureter it can cause small cuts and bleeding, seen as a pink or red colour in the urine.

  • Kidney failure - in a few cases, the stone can grow inside the kidney to such an extent that it completely blocks urine flow. This can lead to permanent kidney damage.


Why do kidney stones form?

Usually, no cause can be found but kidney stones are more likely if the urine is concentrated (for example when working or exercising in a hot climate). Occasionally a stone can be caused by certain medications or rare medical conditions.


x-ray test for kidney stonesWhat tests can be performed for kidney stones?

Your specialist may want to perform blood tests, urine tests, or scans. These tests will aim to detect the presence of a stone, its location, and any blockage to the flow of urine.

Often, a special x-ray called an 'IVU' is taken - this uses special dye to outline the kidneys, bladder and tubes (see the picture to the left), and show up any stones and blockages.



How are stones treated?

Most stones will pass through on their own within a day or two. You will need to drink lots of fluid and take strong painkillers - it is common to stay in hospital during this time to be given very strong painkillers and check that the stone passes through.

If a stone remains stuck and continues to cause symptoms then treatment may be needed. The form of treatment often depends on the type of stone, its size, and its location. Various options include:

  • Ureteroscopy - under anaesthetic, a telescope is passed up into the bladder and then into the ureter. The specialist can now see the stone and use Laser or vibration to break up the stone.

  • ESWL - 'Extracorporeal Shock Wave Lithotripsy' uses high energy shock waves to break up the stone, usually whilst you are awake. The machine is on the outside of the body and aimed at the region the stone is in - the shock waves are given in pulses and can make you feel a bit bruised afterwards.

  • PCNL - 'Percutaneous nephrolithotomy' is where a thin tube is passed through the skin into the kidney, whilst you are under anaesthetic. The tube breaks up the stone and removes the fragments.

  • Open surgery - if the above methods fail then open surgery may rarely be needed. Under anaesthetic, a cut is made in the skin to allow access to the kidney and ureter. The stone can now be removed by the specialist.



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