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Kidney & ureteric stones

From a single calculus to complex staghorn and multi-tract stone burdens, cleared by the least invasive route that will actually work.

Overview

What it is

Stones cause trouble in two different ways. A small stone moving down the ureter causes severe, colicky pain. A large stone sitting quietly in the kidney may cause no pain at all while slowly damaging the kidney behind it — which is why a painless stone still needs a plan.

The right operation depends on the size, position and hardness of the stone and on your own anatomy. Clearing the stone is only half the job; working out why it formed is what stops the next one.

Symptoms you may notice

  • Severe pain in the loin, radiating to the groin
  • Pain that comes in waves rather than staying constant
  • Blood in the urine, visible or on testing
  • Nausea and vomiting with the pain
  • Burning on passing urine, or needing to go urgently
  • Passing gravel or small stone fragments

Get seen promptly if

  • Flank pain with fever or shaking chills — an infected, obstructed kidney is an emergency
  • Pain in a single functioning kidney
  • Passing no urine at all

How it is assessed

  • Non-contrast CT of the kidneys, ureters and bladder — the definitive test
  • Ultrasound, particularly in pregnancy and in children
  • Urine culture before any procedure
  • Kidney function and, where relevant, a metabolic stone screen
  • Stone analysis after treatment, to guide prevention
Treatment

What the options actually involve

RIRSA flexible scope passed up the natural passage, with laser fragmentation. No incision at all.
PCNLA keyhole tract through the flank into the kidney, for large and staghorn stones.
ECIRSA combined approach for the most complex multi-tract stone burdens.
URSLFor stones lodged in the ureter, cleared with a semi-rigid scope and laser.
Medical managementSmall stones may pass with fluids, analgesia and medical expulsive therapy.

Have a scan or report about this already?

Send it before your appointment. The consultation then starts from your findings rather than from scratch.

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