How to Identify and Treat Kidney Stones

Kidney stones move from your kidneys into your ureter, the narrow tube that connects the kidney and the bladder. Here the stone can get stuck, causing severe pain, usually in the side. Noah Schenkman, MD, discusses the various ways kidney stones can be treated.

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Kidney stones are small calcifications that form in the inner lining of the kidney. This stone is often asymptomatic until it passes down into the urinary tract.

When it goes into the ureter, a tube that goes between the kidney and the bladder, that tube is very narrow and this stone will get stuck. It'll cause severe pain— usually a pain in the side.

The patient may have blood in their urine and may be very uncomfortable. A lot of these patients will end up in our emergency department.

Stones often will pass out through the urinary tract on their own if they're small enough. The larger stones usually need treatment.

We also have a lot of minimally invasive treatment options for kidney stones. One is just medication and time; hoping it'll pass. This for the smaller stones.

For stones that are larger, or that we don't think are going to pass, we have ureteroscopy. This is where we take a very narrow scope and are able to pass it through the bladder into the ureter. Then we use a laser to break the stone into small pieces and remove those pieces.

We also have shockwaves lithotripsy, which involves no invasion into the body. The patient lays on a special machine that passes shock waves. These waves are very powerful, and they're focused right on the stone. They crack this stone into little pieces of sand, and then the patient passes the sand out.

Then the most invasive, which is still minimally invasive, is our percutaneous nephrolithotomy, where we make a small incision in the patient's back. Under image guidance with x rays and fluoroscopy, we place a wire and then a scope into the patient's kidney. Then using either laser or ultrasonic lithotripter, we break the stone into little pieces and remove the pieces.