Kidney Stones
Kidney stones are hard deposits of minerals and salts that form in the kidneys and can move into the urinary tract. They are a common cause of severe pain and may recur if underlying risk factors are not addressed.
At The Medical Group of New Jersey, we provide rapid diagnosis, effective pain management, and prevention strategies to reduce recurrence.
Symptom Onset & Initial Evaluation
Symptoms often begin suddenly and may include:
- Severe flank or back pain
- Pain radiating to the lower abdomen or groin
- Nausea or vomiting
- Blood in the urine
- Frequent or painful urination
Evaluation
An evaluation typically consists of:
- Review of symptom timing and severity
- Assessment of hydration and dietary habits
- Evaluation of any prior stone history
Diagnosis & Risk Assessment
Accurate diagnosis is essential to confirm the presence of a kidney stone, determine its size and location, and identify any underlying causes, especially in patients with recurrent stones.
Your urologist will tailor testing based on your symptoms and medical history. Common evaluations may include:
Imaging Studies: Imaging helps confirm the diagnosis and guides treatment decisions. This may include a CT scan (non-contrast) and/or an ultrasound.
Urine Testing:
- Urinalysis: Checks for blood, infection, and crystal patterns that may suggest the type of stone
- Urine culture: Ordered if infection is suspected
Blood Tests: These help evaluate kidney function and identify metabolic contributors and may include:
- Creatinine and BUN: Assess kidney function
- Calcium levels: Elevated levels may suggest calcium-based stones
- Uric acid: High levels can contribute to uric acid stones
- Electrolytes: Help evaluate overall metabolic balance
Additional Testing for Recurrent Stones
If you’ve had more than one stone, your provider may recommend a more detailed evaluation to prevent future episodes:
- Stone analysis: If a stone is passed or removed, it is analyzed to determine its composition (e.g., calcium oxalate, uric acid)
- 24-hour urine collection: Measures urine volume and levels of calcium, oxalate, citrate, uric acid, and sodium to identify risk factors
Treatment & Management
Treatment depends on the size, location, and severity of symptoms, as well as whether the stone is causing obstruction or infection. Your urologist will walk you through the safest and most effective options.
Small Stones (Often Pass Naturally)
Many small stones can pass on their own with supportive care. Treatment typically focuses on comfort and helping the stone move through the urinary tract:
- Hydration: Increasing fluid intake helps flush the urinary system
- Pain management: Anti-inflammatory medications or other pain relievers
- Medical expulsive therapy: Medications (such as alpha-blockers) may be prescribed to relax the ureter and make passage easier
Your provider will also guide you on what to watch for, such as worsening pain, fever, or inability to urinate, which may require urgent care.
Larger or Obstructing Stones
If a stone is too large to pass, causing significant pain, or blocking urine flow, procedural treatment may be recommended:
- Shock Wave Lithotripsy (SWL): Uses external sound waves to break the stone into smaller pieces that can pass naturally
- Ureteroscopy with Laser Lithotripsy: A small scope is passed through the urinary tract to locate and break up the stone with a laser; fragments are then removed or passed
- Percutaneous Nephrolithotomy (PCNL): A minimally invasive surgical procedure used for large or complex stones, where the stone is removed through a small incision in the back
Your urologist will recommend the most appropriate option based on your specific situation, with a focus on safety, effectiveness, and recovery time.
Monitoring & Follow-Up
Follow-up imaging ensures stone passage or treatment success. Additionally, your provider will discuss preventative measures such as:
- Increased fluid intake
- Dietary adjustments (salt, oxalate, protein)
- Medications for high-risk patients