Patient Information

English

Treatment of Kidney and Ureteral Stones

The underlined terms are listed in the glossary.

You have been diagnosed with a kidney or ureteral

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for you.

right kidney

left kidney

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ureters

Your symptoms
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The kind of treatment available at your hospital
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<RXUSHUVRQDOSUHIHUHQFHVDQGYDOXHV

bladder

Not all stones require treatment. You need treatment

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DQGQRQHPHUJHQF\VLWXDWLRQV

urethra

Fig. 1: The urinary tract.

Patient Information - Treatment of Kidney and Ureteral Stones

Page 1 / 11

Treatment of emergency situations

Acute renal colic
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VWRQHWKDWEORFNVWKHureter*RWRWKHIDPLO\GRFWRURU
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relieve the pain.

kidney
JJ-stent

Pain is usually relieved with NSAIDs (non-steroidal

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RSLRLGV 8VXDOO\ WKH\ DUH LQMHFWHG GLUHFWO\ LQWR WKH

ureter

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make you nauseous.
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ureteral stone

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%\ SODFLQJ D XUHWHUDO JJ-stent in your ureter

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through your urethra (Fig. 2)

By inserting a SHUFXWDQHRXV QHSKURVWRP\
tube LQWR \RXU NLGQH\ GLUHFWO\ WKURXJK WKH VNLQ
(Fig. 3a and 3b)

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Fig.2: A JJ-stent is inserted to make sure

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bladder

urethra

Patient Information - Treatment of Kidney and Ureteral Stones

Page 2 / 11

percutaneous
nephrostomy tube

skin
percutaneous
nephrostomy
tube

catheter
bag
bladder

Fig. 3a: A percutaneous nephrostomy tube is

used to drain urine directly from the kidney into
the catheter bag.

Fig. 3b: A percutaneous nephrostomy tube

inside the kidney.

Obstructed and infected kidney

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Patient Information - Treatment of Kidney and Ureteral Stones

Page 3 / 11

Treatment of non-emergency situations

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does not get worse.

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options with you.
Dissolving your stone

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FDQ SUHVFULEH GUXJV WR HDVH WKH SURFHVV 7KLV LV
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Conservative stone treatment

Most kidney or ureteral stones will leave your body

If you suffer from XULFDFLGVWRQHVLWPD\EHSRVVLEOH

WRGLVVROYH\RXUVWRQH7KLVLVGRQHE\LQFUHDVLQJWKH
pH-value of your urine to make it alkaline rather than
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the pH-value of your urine at home by using a
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Active stone treatment

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the stone moves. If you have a very small stone there
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Kidney or ureteral stones should be treated if they

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You are at high risk of forming another stone (See

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passing it

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Metabolic Evaluation for Kidney and Ureteral

Stones
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Your stone is very large

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Medical Expulsive Therapy

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HIIHFWLYHIRUXUHWHUDOVWRQHV

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It seems too big to pass with urine

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Your kidneys have stopped or may stop to

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and SHUFXWDQHRXV QHSKUROLWKRWRP\ 31/ (DFK RI
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It is important to talk about your symptoms and test
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treatment option for you.

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and if your kidneysFRQWLQXHWRIXQFWLRQZHOO

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Patient Information - Treatment of Kidney and Ureteral Stones

Page 4 / 11

Shock-wave lithotripsy (SWL)

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VKRUW SXOVHV RI KLJK HQHUJ\ VRXQG ZDYHV DUH WUDQVPLWWHG WR WKH VWRQH WKURXJK WKH VNLQ7KH VWRQH DEVRUEV WKH
HQHUJ\RIWKHVKRFNZDYHVDQGWKLVEUHDNVLWLQWRVPDOOHUSLHFHV7KHIUDJPHQWVWKHQSDVVZLWKXULQH(Fig. 4).
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DQG\RXUSK\VLFDOFRQGLWLRQ

stone
fragments

kidney
stones

focused
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Go Online
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standard treatment option.

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Patient Information - Treatment of Kidney and Ureteral Stones

Page 5 / 11

How is SWL performed?

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ORFDWLRQRI\RXUVWRQHLVGHWHUPLQHGE\ultrasound or x-ray.

x-ray

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generator

Fig. 5: A common type of SWL machine.

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Patient Information - Treatment of Kidney and Ureteral Stones

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When is SWL not recommended?

There are several FRQWUDLQGLFDWLRQV for SWL that

How long will it take me to get back to my

normal daily activities?

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You are pregnant

You have high risk of severe bleeding
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Try to drink more than 2 litres every day. If you have
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DIWHUWKHSURFHGXUH

VWRQHV

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You have an aneurysm
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<RXU VWRQH LV YHU\ KDUG IRU LQVWDQFH F\VWLQH

for stone analysis.

Will I be stone free directly after treatment?

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These fragments will pass with urine in the days or
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stone fragments.

How do I prepare for the procedure?

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WR SUHSDUH IRU WKH SURFHGXUH ,I \RX WDNH DQ\

<RXUGRFWRUZLOOJLYH\RXDWLPHVFKHGXOHIRUUHJXODU
FRQWUROYLVLWVLQWKHUVWZHHNVDIWHU6:/
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Develop a fever
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Still have blood in your urine more than 2 days
after the treatment

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the treatment.

Advantages of SWL
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t

No need for anaesthesia

Disadvantages of SWL
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of the stone will pass in the following days or
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You

may

need

multiple

sessions

for

larger stones

Patient Information - Treatment of Kidney and Ureteral Stones

Page 7 / 11

Ureteroscopy (URS)
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RIFRPSOLFDWLRQVLVORZ

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D VSHFLDO EDVNHW (Fig. 7). If the stone is too big to
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fragments are removed.

How is URS performed?

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WKHVWRQHDULJLGRUDH[LEOHXUHWHURVFRSH is used.
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(Fig. 2). The stent will be removed when your urine
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between several days and a few weeks.

virtually every point within the kidney (Fig. 6).

kidney

ureter

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Patient Information - Treatment of Kidney and Ureteral Stones

Page 8 / 11

When should I consider URS?

If your stone is not large (generally under 2
FHQWLPHWUHV856LVDQDOWHUQDWLYHWR6:/$OWKRXJK
URS is more invasive than SWL and requires
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and URS in your individual situation.

When is URS not recommended?

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How do I prepare for the procedure?

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How long will it take me to get back to my

normal daily activities?
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SURFHGXUHDQGUHWXUQWR\RXUQRUPDOGDLO\DFWLYLWLHV
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GD\V,ID--VWHQWZDVSODFHGGXULQJWKHSURFHGXUH
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EDFNWRQRUPDO
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Develop a fever
t
)HHOSDLQLQ\RXUNLGQH\RUDQN

Advantages of URS
t

Immediate stone removal

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Disadvantages of URS
t

Requires anaesthesia

t

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Fig. 7: A stone is pulled from the ureter using a basket.

anaesthesia.

basket
ureter

ureteral stone

ureteroscope
bladder

urethra
ureteroscope

Patient Information - Treatment of Kidney and Ureteral Stones

Page 9 / 11

Percutaneous Nephrolithotomy (PNL)

31/LVDVXUJHU\WRUHPRYHODUJHVWRQHVGLUHFWO\IURP
the kidney. The advantage is that even very large
stones are removed in a single operation (Fig. 8a and

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all stone fragments are removed. Sometimes a JJstent (Fig. 2) RU D SHUFXWDQHRXV QHSKURVWRP\ WXEH

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LQYDVLYH DQG WKHUH LV D KLJKHU ULVN RI FRPSOLFDWLRQV

(Fig. 3)LVSODFHGWRPDNHVXUHWKDWXULQHFDQOHDYH
your kidney.

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and fever.

When should I consider PNL?

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How is PNL performed?

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WRWKHXUHWHU<RXUGRFWRUPD\DOVRGLVFXVV31/DVD

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WKHQHSKURVFRSH'HSHQGLQJRQWKHVL]HRIWKHVWRQH

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You have more than one stone

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Your stone is very hard

LW LV HLWKHU UHPRYHG FRPSOHWHO\ RU LW LV EURNHQ LQWR
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nephroscope

kidney
stones
bladder
nephroscope

Fig. 8a: A nephroscope is used

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the kidney.

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DVLQJOHSURFHGXUHZLWKDQHSKURVFRSH

Patient Information - Treatment of Kidney and Ureteral Stones

Page 10 / 11

When is PNL not recommended?

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DUH VRPH FRQWUDLQGLFDWLRQV EHFDXVH WKH VWRQH
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LPSRUWDQWWRGLVFXVV\RXULQGLYLGXDOVLWXDWLRQZLWKWKH

How long will it take me to get back to my

normal daily activities?
After PNL you will stay in the hospital for some days. in
WKHFDVHWKDW\RXKDYHDSHUFXWDQHRXVQHSKURVWRP\
WXEH\RXZLOOEHGLVFKDUJHGZKHQWKHGRFWRURUQXUVH
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How do I prepare for the procedure?

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Develop a fever
t
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Still have blood in your urine a week after

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SUHSDUHIRUWKHRSHUDWLRQ<RXPXVWQRWHDWGULQNRU
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for general anaesthesia.

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the surgery

Advantages of PNL
t

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during one single operation

Disadvantages of PNL
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Requires general anaesthesia

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Longer hospital stay

This information was last updated in June 2012.

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Patient Information - Treatment of Kidney and Ureteral Stones

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