Kidney stone treatment

Insertion / removal of stent in ureter

Please be aware that the following prices are a guide price. Your final price will be confirmed in writing following your consultation and any necessary diagnostic tests.

Patient pathway	Initial consultation	Diagnostic Investigations	Main treatment	Post discharge care	Guide price
Hospital fees	N/A	Not included	£5,550	Included	£5,550
Consultants fees from	£200	N/A	Included	Included	£200
Guide price	£5,750

There are four main types of kidney stones.

Calcium oxalate

This is the most common type of kidney stone and accounts for 80% of cases. Calcium oxalate stones form when calcium combines with oxalate in the urine. They may be caused by not consuming enough calcium and insufficient fluid intake.

Uric acid

Uric acid is a waste product that occurs due to chemical processes in the body. Uric acid crystals do not dissolve well in urine and may form stones.

You may be more likely to develop this type of kidney stone if you:

• Are overweight
• Have gout
• Have type 2 diabetes
• Have chronic (long-term) diarrhoea
• Eat a diet high in animal protein and low in fruit and vegetables

Struvite

Struvite stones are less common and usually occur due to chronic urinary tract infections (UTIs).

Cystine

This is a rare type of kidney stone that accounts for around 1% of cases. Cystine kidney stones occur due to a rare inherited disorder called cystinuria where there is too much of an amino acid called cystine in the urine.

Small kidney stones may have mild or no symptoms and usually pass out of the body without any issues. You may not be aware that you have them.

Larger kidney stones can get stuck in the ureter, and partially block the flow of urine causing the ureter to spasm in an attempt to push the stone out. Symptoms may include:

• Severe sharp pain in your side and back
• Pain in the side of your abdomen, groin, or testicles
• Pain that comes and goes and varies in severity
• Burning or pain when urinating
• Cloudy, strong-smelling urine
• Frequent need to urinate
• Passing small amounts of urine
• Fever (a temperature above 38C)
• Nausea
• Vomiting
• Blood in your urine (may be pink, red, or brown)

Kidney stones form due to a build-up of certain chemicals in your urine. An excess of these chemicals may be due to a medical condition or other factors such as dehydration and diet.

There is often no single answer for what causes kidney stones, though certain things can increase your risk. They are most common between the ages of twenty and fifty and affect more men than women.

Some things that may increase your risk of kidney stones include:

• A family or personal history of kidney stones
• A diet high in protein, salt, or sugar
• Dehydration
• Obesity
• Digestive diseases like inflammatory bowel disease
• Gastric bypass surgery
• Some medications and supplements such as vitamin C supplements, antacids, aspirin, diuretics, certain antibiotics, and some medications used to treat HIV, migraines, epilepsy and depression
• Some medical conditions including cystinuria, renal tubular acidosis, hyperparathyroidism and repeated urinary tract infections (UTIs)

At your first consultation, you will usually be seen by a consultant urologist, a doctor specialising in conditions affecting the urinary system. Your consultant will ask you about your symptoms, general health, and medical history. They will perform a physical examination.

Your consultant may be able to diagnose kidney stones from your symptoms and medical history. This is more likely if you've had kidney stones before.

In other cases, your consultant will order tests to confirm your diagnosis. These may include:

• Urine test
• Blood tests to check your kidney function and calcium and uric acid levels
• CT or ultrasound scan
• Analysis of any stones you have passed

At Circle Health Group, your first appointment is very important as it's where we get to know you, discuss your expectations for treatment and encourage you to ask any questions you may have. It is important to us that you are as well-informed and comfortable as possible before, during, and after your treatment, so please discuss any concerns or ask any questions during your appointment.

After making a diagnosis, your consultant will discuss possible treatment options with you and decide on the best option based on your symptoms and diagnosis.

Treatment for kidney stones depends on the size of the stone. Most stones are small enough to pass without treatment.

Small kidney stones

Kidney stones can be very painful as they pass through the ureter. Your consultant may prescribe painkillers and medication to stop you from feeling sick. They may also prescribe medications called alpha-blockers to help your stones pass. Alpha blockers work by relaxing your ureter, which makes your stones easier to pass and reduces pain.

Some things you can do to relieve discomfort and help your stones pass more quickly include:

• Drink plenty of fluids such as water, tea, and coffee. Avoid fizzy, sugary drinks and alcohol
• Cut down on salt
• Apply a heat pack to where you have pain
• Take warm baths

Large kidney stones

If your kidney stones are too big to pass naturally, are causing severe pain, or affecting your kidney function, you may need treatment to remove them.

There are three main types of treatment to remove kidney stones:

• Extracorporeal shockwave lithotripsy (ESWL)
• Ureteroscopy
• Percutaneous nephrolithotomy (PCNL)

The type of treatment you have depends on how big your kidney stones are, and where they are located. In some cases, your kidney stones may be removed using open surgery though this is rare.

Your consultant will tell you everything you need to do to prepare for your treatment. If there's anything you're not sure about, or if you have any questions, speak to your consultant, or call the hospital for advice.

Being well-prepared for your treatment will help to ease any anxiety you may have as well as allow your procedure and recovery to go more smoothly.

Before your kidney stone treatment, tell your consultant about any medical conditions or allergies you have and any medication, including over-the-counter medicines you are taking.

Your consultant may tell you to stop taking some medications like blood thinners before your treatment. This is to reduce the risk of bleeding during and after your surgery.

You may need to stop eating and drinking a few hours before your procedure. Check with your healthcare team when you can safely eat and drink before your kidney stone treatment.

What lifestyle changes can I make before my surgery?

Being in optimal health before your surgery can reduce the risk of complications and speed up your recovery.

To make sure you are as healthy as possible before your surgery:

• Eat a healthy, balanced diet with plenty of fruit, vegetables, lean proteins, and whole grains
• If you smoke, try to stop at least eight weeks before your surgery
• Avoid alcohol for a few days before and after your surgery. Alcohol thins the blood and can increase the risk of bleeding
• Take regular exercise

The details of your procedure will differ depending on what type of treatment you have as well as factors personal to you.

Extracorporeal shockwave lithotripsy (ESWL)

This is a non-invasive procedure where high-frequency sound waves (ultrasound) are used to locate your kidney stone and a machine sends shock waves to break the stone into smaller pieces. The smaller stone fragments can then be passed out of your body in your urine.

This treatment can be painful, so the procedure is usually performed under sedation or light anaesthesia. ESWL takes around forty to sixty minutes. You may need more than one session of ESWL to fully treat your kidney stones.

Ureteroscopy (laser kidney stone surgery)

This is a procedure where a long, thin tube with a light and a camera (ureteroscope) is passed through the urethra (the tube from which you pass urine) to the bladder. The ureteroscope is then passed into your ureter to where the stone is located. Your consultant can then either remove the stone using special surgical instruments or use a laser to break the stone into smaller pieces so it can be passed in your urine.

Ureteroscopy is performed under general anaesthetic, meaning you'll be asleep during the procedure.

Percutaneous nephrolithotomy (PCNL)

If your kidney stone is particularly large or complicated, your consultant may recommend a procedure called percutaneous nephrolithotomy (PCNL). This is a type of surgery where an incision (cut) is made into your back and a thin telescopic tube called a nephroscope is inserted into your kidney. The stone is then either surgically removed or broken down into smaller pieces using a laser. PCNL is performed under general anaesthetic.

After a ureteroscopy or PCNL, your consultant may leave a thin, rigid tube called a stent in your ureter to keep it open and allow the stone to pass more easily. This will be removed four to ten days after the procedure.

Recovery from any type of surgery is different for everyone and depends on factors such as your age, general health and whether or not there were any complications during your surgery. Your consultant will be able to give you an estimated recovery timeline based on your individual circumstances.

After your kidney stone treatment, you may feel sore for a few days. Your consultant will prescribe medication to manage this. You may notice blood in your urine for several days after your procedure.

Your consultant may ask you to collect any stones you pass and drop them at the hospital for analysis. You will be given instructions on how to do this. Analysis of your kidney stone can determine the type of kidney stone you have and what may be causing them. This can help reduce your risk of developing kidney stones in the future.

Drink plenty of water during your recovery to help flush any stone fragments from your system.

Follow your consultant's instructions carefully during your recovery and call the hospital if you have any questions or concerns.

How many nights will I need to stay in hospital?

ESWL and ureteroscopy are normally performed as day case procedures meaning you'll usually go home the same day. In some cases, you may need to spend one night in hospital.

You'll need to spend one or two nights in hospital after percutaneous nephrolithotomy.

Will I be able to drive home?

You will not be able to drive yourself home from hospital after your kidney stone treatment. Please arrange for someone to collect you, or we can organise a taxi if you prefer.

How soon can I go back to work?

How soon you can go back to work after your kidney stone treatment depends on what type of procedure you had, your individual recovery, and the type of job you do. Most people return to work within a day or two of ESWL or ureteroscopy, and between one and two weeks after PCNL.

Talk to your consultant about when you can expect to return to work after your kidney stone treatment.

How soon can I drive?

You should not drive for at least twenty-four hours of having a general anaesthetic as your concentration and reaction times may still be impaired. You can drive when you can sit comfortably without pain, safely control your vehicle, and perform an emergency stop.

When will I be back to normal?

Most people recover from ESWL and ureteroscopy within a few days.

Recovery from percutaneous nephrolithotomy (PCNL) normally takes around one or two weeks. Avoid heavy lifting, pushing, or pulling for two to four weeks after your PCNL.

As with all types of surgery, kidney stone treatment carries a small risk of complications. Your consultant will explain all the possible risks and complications before your surgery and answer any questions you may have about your procedure.

Possible complications of any surgery include:

• Bleeding
• Infection
• Blood clots
• Adverse reactions to the anaesthetic

Possible complications specific to kidney stone treatment include:

• Sepsis - infection of the blood that can spread through the body
• Injury to the ureter
• Blocked ureter due to stone fragments
• Bleeding
• Urinary tract infection (UTI)
• Pain

In some cases, kidney stones cannot be prevented, but there are a few things you can do to reduce your risk. It's easier to prevent getting kidney stones again if you know what caused your previous kidney stones.

Drink plenty of fluids

Water is best, but tea, coffee and juices also count towards your daily fluid intake. Limit fizzy, or sugary drinks and alcohol. You should aim for at least eight to ten glasses a day, more if it's hot, or if you are very active. A good way to check that you are drinking enough is by the colour of your urine. If your urine is light yellow (straw-coloured) or clear, this means you are well hydrated whereas dark-coloured urine may indicate that you are not drinking enough.

Eat more fruit and vegetables

Fruits and vegetables contain potassium, magnesium, citrate, phytate, antioxidants and fibre which help prevent kidney stones from forming.

Limit animal protein in your diet

Animal proteins make your urine more acidic which may increase your risk of developing kidney stones.

Reduce your salt intake

Salt can cause calcium and cystine in your urine to increase, leading to some types of kidney stones.

Lose weight if you need to

Being overweight may increase the amount of calcium, oxalate and uric acid in your urine which can increase your risk of some types of kidney stones.

Take medication

In some cases, your consultant may prescribe medication to prevent future kidney stones. The type of medication will depend on the type of stones you had.

Medications may include:

• Potassium citrate - to increase citrate and PH levels in the urine
• Antibiotics - to treat or prevent infection
• Allopurinol - to treat high levels of uric acid
• Diuretics - to flush out excess water
• Mercaptopropionyl glycine - an antioxidant used to prevent the formation of cystine stones

We answer some of your most commonly asked questions about kidney stone treatment.

What is the best treatment for kidney stones?

The best treatment for kidney stones depends on how large your stones are, where they are located, how severe your symptoms are, and whether there is any damage to your kidneys. Some kidney stones pass on their own without treatment, but others need to be removed by shockwave treatment or surgery. Your consultant will decide on the best treatment for you, based on your individual circumstances.

Do kidney stones need treatment?

Not all kidney stones need treatment. Smaller stones usually pass by themselves but may be very painful. You can help your kidney stone pass by drinking plenty of water to help 'flush' the stone out. Your consultant may prescribe medication to help the stone pass more easily or relieve symptoms such as pain and nausea. If your stones are large, or you are in severe pain, your consultant may recommend treatment to remove them.

Is laser treatment for kidney stones painful?

Lasers may be used to break kidney stones into smaller pieces during a ureteroscopy. A ureteroscopy is performed under general anaesthetic which means you'll be asleep during the procedure and won't feel any pain.

You may have some post-operative pain for a few days after your ureteroscopy. Your consultant will prescribe pain medications to manage this.

Is laser treatment for kidney stones safe?

Laser treatment for kidney stones is a generally safe procedure with a low risk of complications. It is normally performed as a day case and most people return to normal activities within a day or two. As with all surgical procedures, there is a small risk of complications during ureteroscopy and laser treatment. Your consultant will discuss all the possible risks and complications with you before your procedure so that you can make an informed decision.

At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant or learn more about kidney stone treatment, book your appointment online today or call a member of our team directly on 0141 300 5009.

Content reviewed by Circle in-house team in March 2023. Next review due March 2026

1. Treatment: Kidney stones, NHS
2. Treatment for kidney stones, National Institute for Diabetes and Digestive and Kidney Diseases
3. Kidney Stones, National Kidney Foundation
4. Kidney stones, Urology Care Foundation