Understanding what is the best option for treating your kidney stone can be difficult. In our new chart, we summarize the benefits and drawbacks of each surgical option. While it still won’t make the decision for you, it can help you to make an informed decision when talking to your urologist. For more detailed information and videos, see our treatment pages.
We always welcome feedback. Let us know if you have suggestions to improve the chart by leaving a comment below.
My fiance has 20.1mm stone in his left kidney. his kidney is slightly bulged due to the stone. Can the stone be treated naturally or with medicines but without pcnl / lithotripsy?
my urologist told me I had to options for my kidney stone. the first was shock wave and a stent for about 4 weeks. the second was to go up my you know what with a laser to break up the stone and a stent for about a week. since I had this done before and had a stent before I chose option two. well this time he couldn’t break up the stone and the stent is still in there. when I went to urinate it felt like someone was stabbing me in my flank. oh my god did this hurt! after two days it doesn’t hurt. the stone is still there. so now I will go with option one. my question is. will he leave the same stent in there while doing the shock wave? my second question is can a jj stent be removed while the stone is still lodged in my kidney tube called the uterer?thanks.
My mother has 4cm stone her urinary bladder, she is 78 years old, can she just undergo shock wave lithotripsy procedures
No. A 4cm stone is too large to be handled by lithotripsy,
I have an oval 11mm by 6 mm stone in my left renal pelvis. I do have a number of other stones as well biggest being 4mm in my right kidney. Have been drinking lots of water using lemon and ACV to help dissolve the stones. Also got acetaminophen and uroxatral from the doctor. Trying Chanca Piedra as well. Waiting to get scheduled for shock wave treatment. Hoping to pass stones before going in for this treatment. Each day brings new challenges. Today bleeding. A few days ago pain was bad and threw up. Hope to resolve this situation very soon.
I first went to ER in early March (it’s early July now). CT showed a stone near the bladder and several in the kidney. I got an X-ray which I was able to see during pre op consultation with the urologist. It looked like a little cloud of stones in one area of my right kidney (not solid) but they measured it at 1.2 cm across. Due to a couple delays, I just did the ureteroscopy 4 days ago and have a JJ stent. I have not had any big agony since the first episode in March, but I certainly could tell that “something” was in my kidney.
My wife told me that the urologist said that when they got the camera into my kidney, they could not see the stone(s). He did see a “membrane” in the area and decided to cut through it with the laser, at which point, 20 stones came “spilling out”. From my wife’s description of his behavior (shaking his head while telling the story), it sounds like he had never seen or heard of such a thing.
I don’t know if he had to break any of them up further or whether they were small enough to come out relatively unassisted. I’m mostly writing this because I have never read of anyone else who seemed to have a little pocket of stones in the kidney like this.
As regards the stent – as long as I am not trying to urinate it is only mildly bothersome. I really wish someone would have told me what the pain was all about – as far as I can tell, normally when you pee, your ureters clamp down, the urethra opens up, and the bladder contracts. With a stent on one side the ureter tries to clamp down but is held open – when the bladder squeezes, some of the urine is pushed back up into the kidney which hurts “a lot”. The best bet as regards elimination is just to “let it go” and not try to control the flow.
I’m taking hydrocodone/acetaminophen every 6 hours and 600 mg ibuprofen also every 6 hours but offset by 3 hours compared to the other stuff. This reduces the pain from “agony” to “hurts”.
Still a lot of blood in the urine. Going to start drinking more water now that I am not terrified of urinating. Yesterday I tried about 5 oz. water (150 ml) every hour, then I stopped counting so carefully and just drank more as it was a very hot day.
Stent removal scheduled for 6 days hence. Will follow up with any profound revelations.
June 25 2015 just had shock wave done on my right kidney because of a stone that delevope during time it was 7 mm stone I starp pain but after I had that surgery I was in so much pain I had go back to the hospital to get a shot of morphine the pain passing is so horrible my suggestion is someone who doing the shock wave treatment ask question first about pain and what ever else what does this procedure does to your organs since it was my first stone I didn’t ask questions thinking it was not going to harm me in a certain way it really hurts I vomit about 6 time after the procedure I slept all day because of the pain so please ask questions before any procdures
In My Sonography following Impression is seen
moderate right hydronephrosis and proximal hydroureter secondary to 14mm proximal ureteral calculus.Please suggest options to remove it?
i had 16mm kidney stone which i got removed through pcnl on 24th jan 2014.now exactly after one year i got one more kidney stone which is 11mm in size.last time dr tried eswl but in vain.i dont know what to do now.please help
i had 16mm kidney stone which i got removed through pcnl on 24th jan 2014.now exactly after one year i got one more kidney stone which is 11mm in size.last time dr tried eswl but in vain.i dont know what to do now.please help.
Poor me!!! i am tortured by kidney stones. I have surgery five times and lithotripsy twice. i am currently incubating two stones, one in the ureter 12mmx10mm and one in the kidney 10mmx25mm. Every time i pee i feel as though some one is stabbing me in the back with a blunt screw driver. It is so painful!! i cry! this results in a viscious circle. urination=pain so dont drink!! dont drink= stone growth. I know that i am extremly lucky that i live in the u.k with its world renowed N.H.S. which is free from point of entry…… but sometimes free isent always best. I think my stones are too big for the horrors of lithotripsy. Call me a coward but i think lithotripsy is how shall we say? (not nice)
Nice to see your response.My sister, 26 is diagnosed with stones of 6mm size when she complaint heavy pain in stomach after 2-3 recurrence of Urine infection. It is 6mm Rt. lower ureteric calculus with moderate backpressure changes in right. Few mobile internal echoes within the urinary bladder.
Doctor were trying to give hydrotherapy first for 3-4 days and she was in hospital. Now what should be the next action? I am not sure though but it has moved down to urinary track.
Your sister’s was a one sitting case. No necessity for the hospital to keep her there for 3-4days. They just took away a few thousands from your bank account to run their fancy cars at your expense. Sad but true!!!
Hi Dr.Mike.
Nice to see your response.My sister, 26 is diagnosed with stones of 6mm size when she complaint heavy pain in stomach after 2-3 recurrence of Urine infection. It is 6mm Rt. lower ureteric calculus with moderate backpressure changes in right. Few mobile internal echoes within the urinary bladder.
Doctor were trying to give hydrotherapy first for 3-4 days and she was in hospital. Now what should be the next action? I am not sure though but it has moved down to urinary track.
Thanks
Prachi
Your sister’s was a one sitting case. No necessity for the hospital to keep her there for 3-4days. They just took away a few thousands from your bank account to run their fancy cars at your expense. Sad but true!!!
I don’t know if you can help me. I jog and have a history of kidney stones, I just had 2 stones removed by Percutaneous Nephrolithotomy, and was wondering if jogging is bad for the kidneys, and what does jogging do if you have kidney stones? Thank you.
Just had the surgery to remove kidney stone that has been baking in my right kidney for several years, I’ve had no pain. The dr got alot removed but now in a wk I have to go in for shock treatment to see if they can remove the remaining. I was in surgery for 4hrs, its very painful after but I was up and moving within a day and went home in 2days, took me about 1 1/2 wk to fully recover. Therrwill always be some type of risk in anything you do. You just gotta weight your options if you want it gone then do the surgery.
How big was your stone.
My is 4 cm tried lipotripcy several times.
Please let me know, what was the procedure you had.
I was told that after these surgeries you develope high blood pressure and or become a diabetic? My uroligist told me this 2 days before surgery and it scared me out of surgery.
I have a 9 mm stone and right now it is extremely painful. I have ua’s done to check on white blood count only for infection.
I need the stone out but don’t want that either!
Thanks, Darla
I was told that after these surgeries you develope high blood pressure and or become a diabetic? My uroligist told me this 2 days before surgery and it scared me out of surgery.
I have a 9 mm stone and right now it is extremely painful. I have ua’s done to check on white blood count only for infection.
Is this true about diabetic/high blood pressure?
I need the stone out but don’t want that either!
Thanks, Darla
Currently I have a 16mm stone in my left kidney pelvis. I have been having pain in my left side and abdomen for months now, but first sought treatment 1/24/2014. The physicians assistant(PA) prescribed Tylenol with codeine and sent me home to hydrate because I have formed stones in the past and always have passed them on my own(one at Epcot Center!). Predominantly in the past my pain would begin with bladder spasms, then progress up my side and cause nausea and vomiting to the extent that twice my urologist admitted me to the hospital directly and had me hydrated, given pain medications and anti-emetics. These were short stays and generally and IVP would be done I would pass the stone and that was that. This time the pain has persisted and I finally returned to the PA on March 31st. He ordered abdominal xrays and a renal ultrasound. The xrays revealed the stone and I made an appointment with a new urologist. He did CT scan that revealed the stone was in the renal pelvis. His plan is to do shokwave lithotripsy next Monday ad most likely place a stent. I’m concerned now as I saw the chart comparing the procedures and the size of the stones. The urologist did say that it may take several procedures and that it was a possibility that I could end up having all three procedures. Does anyone have experience with a stone this size? I’m already off work due to the pain. I only take the Tylenol with Codeine when absolutely necessary. I’m concerned with how long this is going to take and when I might find relief. I have read many replies on here and realize that each patient is different. I will say that in the past we have correlated the stones with calcium oxylate. I had a 24 urine in the past and managed to collect one stone for evaluation. Ice tea consumption in excess has been correlated with my stones in the past. I did not drink ice tea for years, but have been drinking ice tea more in the past several months especially. Sometimes as much a 50 ounces in a 12 hour period. I would appreciate any insight. I’m female and 46 in the USA. I think fear of the unknown has brought me here!
I am currently going through the same thing with a stone the same size. I had a stent put in on Thursday and it’s been nothing but agony for me I can’t urinate without being brought to almost tears from the pain in my flank. They have me scheduled for the Shockwave therapy but not till 8/7 I really don’t know if I can handle the pain that long the pain pills they prescribed aren’t touching the pain at all. I was just hoping you could give me some insight on how it went for you.
Thank you.
It doesn’t look like anyone has commented on this site for quite a while. I hop I can get a response from the doctor. would you recommend a ureterscopy over lithotripsy in my situation? I just posted below on my kidney stone situation.
Go with whatever your doctor says, both of your stones are passable with little pain if you get painkillers. If there are other complications or its just not passing you can opt for the other procedures. Personally I am a federal employee and I have passed a 6mm stone before on tramadol, harnal D, flomax, and naproxen. The pressure was intense, but not really painful. The more recent stone I had was 11mm and lithrotripsy ended up working, as I am just not a fan of invasive procedures. More importantly is doing followups and endocrinology to make sure you adjust your intake and hopefully prevent future stones as much as possible. I kind of shrugged the first one off as a fluke and am forced to pay more attention to that area of myself now.
I have a 4mm tone in left kidney and 5-6mm stone stuck halfway down my left ureter. the stones are not very visible on an xray. She recommends a ureterscopy to get both of them out and then a stent for 5 days. I have had lithotripsy which was not a problem in the past. I am afraid from reading this site of all the pain. What can I expect. I also have some IC problems that came back and has gotten better and am wondering if this will flare up my bladder again. How long do I have to take off work.
I had two stones in my left kidney one measuring 10mm on the upper pole and the second measuring 6mm in the lower pole. My urologist had removed them by doing RIRS+ DJ stenting. But actually he discussed URS procedure only with me not even the DJ stenting. And the hospital has charged so much for this procedure. Now I want file a suit on the hospital for performing a treatment procedure without even discussing it with me.
My question is in what cases RIRS + DJ stenting is really necessary over URS + DJ stenting.
URS and RIRS are the same thing. URS (Ureteroscopy) and RIRS (Retrograde Intrarenal Surgery) both require stents at the surgeon’s discretion. Most urologists will leave stents if doing URS in the kidney especially if using a laser.
My mom needs PNL for her kidney stone the size of a marble (no pain, though)! We’ve been advised that a radiologist puts in the tube and then three hours later, the urologist does the surgery. That seems like a long time to be under anesthesia! Should we get another opinion?
Usually, this means that the radiologist does his or her part of the procedure (obtaining access into the kidney and leaving a “guidewire” or small tube for the urologist to use) in the radiology department first. This part typically does not include general anesthesia. Then, the patient is brought to the operating room a few hours later for the urologist to perform the actual PCNL procedure. This part would be performed under general anesthesia. So your mom probably wouldn’t be under anesthesia for those 3 hours between the radiology part and the urology part, but just during the actual urology procedure. You can clarify this with her urologist if you want to be sure.
Incidentally, other urologists may choose to arrange the schedule differently. The radiologist and urologist might do both their parts in the same operating room under one anesthesia or the urologist might get access themselves at the time of PCNL surgery without the involvement of radiology. None of these different approaches is necessarily better, it will depend on the experience and preferences of your urologist.
My mom needs PCNL too, but she is being told they are putting the tube in, and doing the actual surgery 3 DAYS later! Is that normal?
My honey has two large kidney stones on the left and same on the right. The right were starting to become an issue so he had lithotrypsy done twice, which did blast both stones on the right side. There were quite a few stones and gravel that passed but now nothing for about 9 days. Another xray showed steinstrasse (stone wall where all the gravel collects in the ureter) creatanine levels came down which can be good or bad as that might be showing the other kidney taking over. no flank pain. little pain that feels like a moving stone on and off, and a few days ago a little blood in the urine. No fever. Question is: how long can one wait like this.. if there is no pain.. a week, few weeks in the hopes that they pass? or is it best to go and do the recommended ureteroscopy? another question on the stent recommendation, as most of the discomfort is always it seems with the stent, if one does the ureteroscopy and clears the steinstrasse.. then why have the stent in for a week, though there would be some swelling in the area it takes sometimes months for the other stone fragments to pass, so if the stent was only in for a week would that not be a mute point? ideally he woull love to wait some more time in case the pass.. the last resort do the ureteroscopy but without a stent, is he risking the life of his kidney? He was taking flowmax but every time he did he got flu like symptoms, fever, aches, coughing, snotty nose.. when he did not take it for a day, it all went away, then he took it again within an hour they were all back. Lots of questions, sorry.. looking forward to hearing your thoughts.
Hi, I have a kidney stone of 4-5mm and my urologist just recommend me the Ureteroscopy, he says the success rate of the Shockwave Lithotripsy is very low, what can I do??
Three years ago I had a 8mm stone and had treatment with shockwave lithotripsy, I wish I would have opted for ureteroscopy the first time but was afraid of getting the stent. Small fragments were left behind that grew into a 20mm stone. Four days ago I had the ureteroscopy and a stent placed which will be in for 2 weeks. The pain medicine managed the pain for the first few days, bleeding lessened hour by hour and today I only have discomfort without any pain medicine. It has been so much better than what I read online!
SWL has a 70% success rate and is that a low success rate?.
AWESOM!!! Thank you for all this info. I am so happy I found this site.
Hi,
My husband is a navy officer. He need to undergo full body check up each time he go on board. This time, one month ago, he has been diagnosed with a kidney stone of 4-5 mm size. He never had any symptoms or pain. He consulted a Nephrologist and he was advised not to do any surgery until it grows or to check up after one year. He was having some Ayurvedic medicine to pass the stone. It did not pass yet. Still no symptom exists. What do we need to do? Which surgey will be good for us. Can any drugs dissolve the stone or pass it? He cannot go on board for work till he get out of this. Disappointed very much.
Unfortunately, most stones cannot be successfully dissolved with medicine. The exception are uric acid stones, which account for about 5-7% of all stones. However, dissolution therapy, even for uric acid stones, can take months to completely dissolve a stone and is not always successful. A urologist can help your husband to determine what his likely stone type is. Uric acid stones, unlike calcium based ones, are usually not well visualized on plain x-rays.
Your husband should see a urologist and will likely need to consider treating his stone with either ureteroscopy or shockwave lithotripsy since he is not able to perform work duties until the stone is gone. Pilots are in a similar situation – if they are found to have a stone, they are grounded until a urologist can treat their stone(s) and declare them stone free. In these situations, waiting for the stone to get larger or waiting another year before rechecking a CT scan is not a viable option.
We wish you luck and are thankful for your husband’s service to the country.
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I have been suffering of kidney stones for almost 10 years now and on June 2010 my doctor stated I had a massive stone that needed to be removed by having the Percutaneous Nephrolithotripsy; which I had on Dec 1st, 2011. They were only able to remove half of the stone due to complications during the surgery which took about 5 hours and a lot of loss of blood. A stent was placed and I have been having a lot of pain on my kidney area, lower part of the stomach on the same side as the kidney stones and Tylenol 3 seems to be the only medicine that has worked for me. In January 17th I had a shockwave surgery to remove 4 out of the 6 stones left and now I am waiting for what should be the final surgery using the same method. What can I do to accelerate the passing of the stones after the last surgery? I have been drinking LOTS of water, but so far I have not passed anything.
Besides having you do you part by drinking water, your physician may choose to have you take tamsulosin. In several studies, this medication (also known by its brand name “Flomax”) appears to improve the chances that your stones will pass and the speed by which they pass. Tamsulosin can also decrease pain associated with passing stone fragments after shockwave lithotrispy. “Efficacy of tamsulosin oral controlled absorption system after extracorporeal shock wave lithotripsy to treat urolithiasis” Georgiev and colleages, Urology 2011.