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Kidney Stone Treatment: When Do You Need Medicines, Endoscopy, Laser or Surgery?

Posted June 17th,2026 by Cura Hospitals

Kidney stones are more frequent now than ever before, intensified by genetics and lifestyle choices. And when they do occur, the pain that comes along with it is one of the worst experiences. It puts patients in a state of panic. 

It’s important to be aware and understand that the pain may be bad, but the treatment is simple and manageable. The correct treatment for you can depend on the size, location, and type of stone, along with your symptoms and overall health.

This blog discusses everything you need to know when dealing with kidney stones.

What Causes Kidney Stones?

Kidney stones occur when the amount of salts and minerals in your urine has increased to the point where it starts to accumulate inside your kidneys. Several factors increase this risk:

  • Dehydration
  • A high in salt, protein, or oxalate-rich diet
  • Genetics
  • Diabetes, obesity, or chronic UTI’s
  • Medicines that affect mineral balance in your body

While small stones may pass without treatment, it is the larger ones that usually need medical attention.

What are the common symptoms of kidney stones?

  • A very sharp, unbearable cramping pain in the lower back or side that comes in waves
  • Pain that moves toward the lower part of your body
  • A burning sensation while urinating
  • Odd colour in your urine like pink, red, or brown 
  • Having a constant urge to urinate but not being able to
  • Vomiting along with pain
  • A fever coupled with chills 

If you are experiencing any of these, it is worth getting evaluated promptly rather than waiting to see if the symptoms pass.

Book your consultation today at Cura Multispeciality Hospitals and get a clear treatment plan built around your condition.

What are the Treatment Options?

  1. Medication and Hydration

Stones smaller than 5mm pass on their own in a significant number of cases with good hydration and pain management. Your doctor may recommend:

  • Pain relievers to help with the pain.
  • Alpha-blockers, which relax the muscles help the stone pass more easily with less discomfort
  • Potassium citrate is given to patients who have stones repeatedly. 
  • Diuretics, are used to increase urine output, which helps reduce mineral buildup.

These treatments help when the stone is small and not causing a blockage. Your urologist will monitor progress over a few weeks before recommending anything further.

  1. Endoscopy or Laser Treatment

When the stone is too large to pass or hasn’t passed by other methods and is causing a blockage, your urologist will recommend an endoscopy. 

When do you need an endoscopy or laser treatment? 

  • The stone is larger than 5 to 7 mm
  • Pain that does not reduce with medication
  • Signs of kidney damage 
  • Inability to pass urine 

Dr. Casey Stork, urologist and assistant professor at the University of Michigan, notes that the technology available for kidney stone management is changing rapidly and now offers patients far more options than ever before, with treatment becoming increasingly precise and less invasive at the same time. 

  1. Surgical Approaches

These are the three main surgical approaches used today:

1. URS (Ureteroscopy) 

A thin, flexible camera is passed through the urethra and bladder into the ureter to locate the stone and a laser is used to break it into smaller pieces, which then pass naturally or are removed. This works well for stones in the ureter and smaller stones in the kidney. It is performed under general anaesthesia, and most patients go home the same day.

2. RIRS (Retrograde Intrarenal Surgery) 

The flexible scope goes to the kidney itself. This makes it suitable for stones sitting deeper inside the kidney that cannot be reached by standard ureteroscopy. Laser energy is used to dust or fragment the stone. RIRS is increasingly preferred for kidney stones up to 2 to 3 cm in size, where a skin incision is not desirable.

3. PCNL (Percutaneous Nephrolithotomy) 

For larger stones, a small incision is made in the back to access the kidney directly. A small camera is inserted through this opening, and the stone is broken up and removed. PCNL is recommended for stones larger than 2 cm or stones that have not responded to other procedures. Recovery is slightly longer, but it offers a higher stone-free rate for larger stones.

Can Kidney Stones Become an Emergency?

In certain situations you cannot wait for an appointment. Go to the emergency department immediately if you have:

  • Severe pain that does not stop for hours even after taking medication
  • The presence of blood in the urine along with a high fever
  • If you are not able to pass urine at all
  • Excessive vomiting
  • If you are experiencing chills, shaking, or a fever above 38.5 degrees Celsius

All of these symptoms could lead to serious kidney damage and require immediate medical attention.

Tests Used to Diagnose Kidney Stones

Your urologist will use a combination of the following:

  • CT scan (non-contrast): The most accurate imaging tool for detecting stones, their size, and exact location
  • Ultrasound: A radiation-free option useful for initial screening, especially in children and pregnant patients
  • X-ray (KUB): Can identify calcium-based stones but may miss smaller or denser stone types
  • Urinalysis: Checks for blood, infection, and mineral imbalances in the urine
  • Blood tests: Assess kidney function and identify metabolic causes of stone formation
  • 24-hour urine collection: Used for patients with recurrent stones to understand what is driving stone formation

Recovery After Minimally Invasive Treatment

One of the biggest concerns patients have is how long recovery takes. Here is a general overview:

  • After URS or RIRS: Most patients go home within 24 hours. A temporary ureteric stent may be placed for a few days to help the ureter heal and allow stone fragments to pass. Mild discomfort and blood-tinged urine are normal for a short period.
  • After PCNL: Hospital stay is typically one to two days. Light activity can usually resume within one to two weeks, with full recovery in three to four weeks.
  • After ESWL (shock wave lithotripsy): This is done as an outpatient procedure. Stone fragments pass over the following days to weeks. Some soreness around the treatment area is expected.

When to Consult Cura’s Urology Team

You do not need to be in severe pain to see a urologist. A consultation is advisable if:

  • You have been told you have a kidney stone but are unsure what to do next
  • You have had kidney stones before and want to understand why they keep coming back
  • You have dull, recurring flank pain that has not been explained
  • You have a family history of kidney stones and want to assess your risk
  • You need a second opinion on a treatment recommendation

Early evaluation leads to simpler treatment. Waiting until the situation becomes urgent often makes it more complicated.

At Cura Multispeciality Hospitals, our urologists provide precise, patient-specific care from first consultation to full recovery. Contact us to schedule your appointment.

Frequently Asked Questions

1. When would a kidney stone require surgery?
When the stone is too large to pass, causes a blockage, is associated with infection, or has not responded to other treatments.

2. What is the first symptom of a kidney stone?
The most common first symptom is a sudden, sharp pain in the lower back or side, often coming in waves. Some people also notice a burning sensation while urinating or a change in urine colour before the pain begins.

3. How to flush out kidney stones quickly?
For small stones, staying well hydrated, drinking 2.5 to 3 litres of water a day, is the most effective way to encourage natural passage. Your doctor may also prescribe alpha-blockers to relax the ureter and help the stone move along faster.

4. What are the causes of kidney stones?
Kidney stones form when minerals and salts in the urine become too concentrated. Common causes include chronic dehydration, a diet high in salt, protein, or oxalates, genetics, obesity, diabetes, and certain medications that affect mineral balance.

5. Is a kidney stone very serious?
Most kidney stones are manageable and not life-threatening. However, if a stone causes a complete blockage, is accompanied by fever and chills, or leads to inability to urinate, it becomes a medical emergency that requires immediate attention. Left untreated, it can lead to serious kidney damage.

References:

  1. Leonardo Ferreira Fontenelle, MD, MPH, PhD, Thiago Dias Sarti, MD, MPH, PhD, 2019, Kidney Stones: Treatment and Prevention, available at, https://www.aafp.org/afp/2019/0415/p490

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