Tamsulosin to relax the ureter and help the stone pass
Surgery is often needed if:
The stone is too large to pass on its own
The stone is growing
The stone is blocking urine flow and causing an infection or kidney damage
The pain cannot be controlled
Today, most treatments are much less invasive than in the past.
Lithotripsy is used to remove stones slightly smaller than a half an inch that are located in the kidney or ureter. It uses sound or shock waves to break up stones. Then, the stone fragments leave the body in the urine. It is also called extracorporeal shock-wave lithotripsy or ESWL.
Procedures performed by passing a special instrument through a small surgical cut in your skin and into your kidney or ureters are used for large stones, or when the kidneys or surrounding areas are incorrectly formed. The stone is removed with a tube (endoscope).
Ureteroscopy may be used for stones in the lower urinary tract.
Rarely, open surgery (nephrolithotomy) may be needed if other methods do not work or are not possible.
Ferrandino MN, Peitrow PK, Preminger GM. Evaluation and medical management of urinary lithiasis In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 46.
Fink HA, Wilt TJ, Eidman KE, et al. Medical management to prevent recurrent nephrolithiasis in adults: a systematic review for an American College of Physicians Clinical Guideline. Ann Intern Med. 2013;158(7):535-43. PMID: 23546565 www.ncbi.nlm.nih.gov/pubmed/23546565.
Fink HA, Wilt TJ, Eidman KE, et al. Recurrent nephrolithiasis in adults: comparative effectiveness of preventive medical strategies [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US) 2012; Report No.: 12-EHC049-EF. PMID: 22896859 www.ncbi.nlm.nih.gov/pubmed/22896859.
Jennifer Sobol, DO, urologist at the Michigan Institute of Urology, West Bloomfield, MI. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.