Dr. Roger Sur, MD, demonstrates kidney stone removal at UC San Diego Health.
Many kidney stones will pass on their own. However, if a stone is too large or if it becomes stuck in the urinary tract, conservative treatment may not be sufficient.
UC San Diego Health's Comprehensive Kidney Stone Center offers innovative and effective options to treat and remove a variety of kidney stones. We specialize in helping people who have recurring kidney stones, complex cases such as large “staghorn” or struvite stones, or medical conditions that may make stones more likely. Our advanced imaging techniques can help determine the size and composition of stones.
Treatment Options for Larger or Problematic Kidney Stones
If you have large stones or stones that cause you problems, your UC San Diego Health physician may recommend one or more of the following treatment options:
- Medical expulsive therapy, which uses alpha blocker medicines such as Flomax (tamsulosin) and Uroxatral (alfuzosin) to help you pass a kidney stone in the ureter. Multiple studies have shown that medications can increase the chance of spontaneous passage, decrease the time to expulsion, decrease the need for pain medications, reduce need for hospitalization and limit the need for surgical intervention to remove the stones. The medications are typically taken over four weeks.
Shock wave lithotripsy, which uses energy from sound waves to break up a kidney stone. It is the least invasive surgical technique and is generally performed on an outpatient basis.
Ureteroscopy, which involves passing a very thin tube (ureteroscope) into the urinary tract to the stone's location, where instruments can then be used to remove the stone or break it up for easier removal. Occasionally, you may need a small hollow tube (ureteral stent) placed in the ureter for a short time to keep it open and drain urine and any stone pieces. Ureteroscopy is often used for stones that have moved from the kidney to the ureter.
Percutaneous nephrolithotomy, which is the most effective way to remove large stones. This surgery generally requires a small (1 cm) incision in the side or back and the use of a scope to remove the kidney stone. This procedure is performed on an inpatient basis.