Kidney stone treatment may involve observation, medicines or a procedure to break up or remove the stone. The right option depends on the stone’s size, location and composition, alongside symptoms, infection and kidney function.
Some stones can safely be monitored. Others need prompt treatment, even if they are small.
Seek urgent assessment for fever or chills with suspected stone pain, inability to urinate, uncontrolled pain or persistent vomiting. An infected, blocked kidney may require emergency drainage.
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For optional reading alongside professional advice, view the Kidney Stone Removal Report. It is an information product, not a substitute for assessment or a guarantee of avoiding a procedure.
Comparing the Main Options
| Option | Main purpose | Important limitation |
|---|---|---|
| Observation | Allow a suitable stone time to pass, or monitor a selected symptom-free kidney stone | Requires follow-up and clear instructions about worsening symptoms |
| Symptom medicines | Control pain and nausea | Do not necessarily remove the stone |
| Medical expulsive therapy | Help selected ureteral stones pass | Not suitable or effective for every stone |
| Dissolution treatment | Chemically dissolve selected stones, particularly uric acid stones | Requires appropriate medication and monitoring |
| Shock-wave lithotripsy | Break a stone into fragments using externally delivered shock waves | Fragments must pass; repeat treatment may be needed |
| Ureteroscopy | Reach and remove or fragment a stone through the urinary tract | Involves instrumentation and usually anaesthesia |
| Percutaneous nephrolithotomy | Remove larger or complex kidney stones through a small opening in the back | More invasive and generally involves hospital care |
1. Observation: When Waiting Can Be Appropriate
A clinician may recommend observation when a stone has a reasonable chance of passing and there are no complications requiring intervention.
Monitoring a symptom-free stone still inside the kidney is a different situation from waiting for a stone in the ureter to pass.
Observation should include a follow-up plan—not simply waiting indefinitely. Ask when you need reassessment and what would trigger a change in treatment.
2. Medicines for Pain and Nausea
Pain relief is an important part of treatment. Anti-inflammatory medicines are commonly used for renal colic when suitable; other options may be needed depending on kidney function, other conditions and current medicines.
Anti-sickness medicines can help with nausea. Persistent vomiting may require hospital treatment.
Do not assume a medicine suitable for another person is appropriate for you. Tell the clinician about kidney disease, pregnancy, stomach bleeding and blood-thinning medicines.
Our kidney stone pain-relief guide covers supportive care in more detail.
3. Medicines That May Help a Stone Pass
An alpha blocker such as tamsulosin may be offered for selected stones in the ureter, particularly those nearer the bladder.
This is called medical expulsive therapy. It does not dissolve the stone, and its benefits depend on the clinical circumstances.
Ask why it is being recommended, what side effects to watch for and when the plan will be reviewed.
4. Treatment That Dissolves Certain Stones
Some uric acid stones can dissolve with prescribed medication that makes urine less acidic. Urine-pH monitoring and follow-up are important.
This approach does not ordinarily dissolve calcium oxalate stones. Home mixtures should not replace prescribed treatment.
Read more about which kidney stones can dissolve.
If you explore the Kidney Stone Removal Report, discuss any recommended medication changes, supplements or alkalising routines with your treating clinician.
5. Shock-Wave Lithotripsy
Shock-wave lithotripsy—also called SWL or ESWL—uses waves directed from outside the body to break a stone into smaller pieces.
It avoids an incision, but it does not guarantee that every fragment will clear. Suitability depends on factors including stone size, location and how readily it can be targeted and broken.
Possible problems include bleeding, infection and fragments blocking urine flow. Some people need another session or a different procedure.
Ask what pain relief or anaesthesia your treatment centre uses and how clearance will be checked afterward.
6. Ureteroscopy and Laser Treatment
During ureteroscopy, a clinician passes a thin scope through the urethra and bladder into the ureter, sometimes continuing into the kidney.
The stone may be retrieved or broken into smaller pieces, often with a laser. There is usually no skin incision.
Many patients go home the same day, although the recovery plan varies. Ask about infection risk, possible urinary-tract injury and whether more than one procedure may be necessary.
7. Percutaneous Nephrolithotomy
Percutaneous nephrolithotomy, usually shortened to PCNL, provides access to the kidney through a small opening in the back.
It is commonly considered for larger or more complex kidney stones. Instruments are used to break up and remove the stone.
Recovery generally involves hospital care. Discuss bleeding, infection, anaesthesia and the possibility of additional treatment with the surgical team.
Why Might You Need a Stent or Drain?
A ureteral stent is a small internal tube that helps urine drain between the kidney and bladder. A nephrostomy drains urine through a tube placed into the kidney from the back.
Drainage may be needed urgently or around a stone procedure. Draining the kidney is not always the same as removing the stone.
If a stent is placed, ask who will arrange its removal or replacement and when that should happen. Keep those instructions with your discharge paperwork.
How to Discuss the Choice With Your Urologist
Bring your scan report and medication list, and ask:
- Where is the stone, and how large is it?
- Is it causing blockage or affecting kidney function?
- Is waiting reasonable in my case?
- What are the benefits and risks of each suitable option?
- Might I need repeat treatment?
- Will I need a stent?
- How will we confirm that treatment worked?
- What should I do if symptoms worsen before my appointment?
There is no single procedure that is best for every person. Your preferences matter alongside the clinical findings.
What Happens After Treatment?
Your clinician may ask you to collect a passed stone or send removed fragments for laboratory analysis.
Some people also need a 24-hour urine collection to investigate why stones form. The results can guide prevention.
Removing the current stone does not eliminate the possibility of another one. See our guides to preventing kidney stones and recurrent kidney stones.
Frequently Asked Questions
Can kidney stones be treated without surgery?
Yes, in suitable cases. Options include observation, medicines and shock-wave treatment. Whether they are appropriate depends on the stone and your health.
Does every painful stone need a procedure?
No. Some pass with medical support. However, persistent pain or complications may change the treatment plan.
Is laser treatment the same as shock-wave lithotripsy?
No. Laser fragmentation generally uses a scope inside the urinary tract. Shock-wave treatment delivers energy from outside the body.
Does a stent remove the stone?
Usually, its main purpose is drainage. Ask whether the stone has already been treated or whether another procedure is planned.
Can a home remedy replace recommended treatment?
A drink or supplement should not replace treatment for obstruction, infection or a stone unlikely to pass safely.
Optional further reading: Kidney Stone Removal Report. Purchasing a report is not necessary to receive appropriate treatment or prevention advice.
Resources
- NIDDK: Treatment for Kidney Stones
- European Association of Urology: Urolithiasis Guidelines
- NHS: Kidney Stones
- MedlinePlus: Shock-Wave Lithotripsy
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Medical disclaimer: This article provides general education and does not replace personalised medical advice, diagnosis or treatment.