Kidney Stone Treatment: Symptoms, Non-Surgical Methods and Laser Technologies

How do kidney stones pass? What are the most effective kidney stone treatment methods? A comprehensive guide to laser lithotripsy (RIRS), ESWL and natural remedies. Read now for a pain-free life.

Introduction: It is Possible to Put an End to Unbearable Pain

Commonly described by the general public as ‘the most severe pain after labour pains,’ kidney stone pain is a health issue that significantly reduces quality of life. However, do not worry; thanks to modern medical technology, kidney stones are no longer a nightmare.

In this guide, we will examine all options in detail, from natural remedies that can be applied at home to state-of-the-art laser treatments such as Flexible Ureteroscopy (RIRS), which are performed without any incisions. Our aim is to help you determine the most suitable treatment path for you and provide you with the right information to regain your health.

What is a Kidney Stone and Why Does it Form?

Kidney stones are hard masses formed by the crystallisation and combination of minerals and salts (calcium, oxalate, uric acid) in the urine. These stones can be as small as a grain of sand or as large as a golf ball.

Types of Kidney Stones

The most important factor in determining the treatment plan is the type of stone:

Calcium Stones: The most common type (75-80%). They are usually in the form of calcium oxalate.

Uric Acid Stones: Associated with insufficient fluid intake and a high-protein diet.

Struvite (Infection) Stones: These stones grow rapidly as a result of urinary tract infections.

Cystine Stones: A rare, genetically inherited type.

Kidney Stone Symptoms: Signals Your Body Gives You

Kidney stones may sometimes cause no symptoms at all while they remain stationary within the kidney (silent stones). However, when the stone moves and enters the urinary tract (ureter), severe symptoms begin.

The most common symptoms are:

Renal Colic: Very severe pain that starts in the back, side (flank) and below the ribs, and comes in waves.

Referred Pain: Pain spreading to the groin and genital area.

Urinary Changes: Pink, red or brown urine (haematuria), cloudiness or foul odour.

Frequent Urination: A constant urge to urinate but only passing small amounts of urine.

Nausea and Vomiting: Severe pain may be accompanied by nausea.

Fever and Chills: If the stone is accompanied by infection, urgent medical attention is required.

Warning: If you experience fever and unbearable pain at the same time, you should seek immediate medical attention at the nearest emergency department.

Diagnostic Methods: Visualising the Stone

Before starting treatment, the size, location and hardness of the stone must be clearly determined.

Ultrasonography: Does not involve radiation and is the first choice method. However, it may not always show small stones or stones that have fallen into the canal.
Computed Tomography (CT): This is the gold standard. It accurately shows the millimetric size, hardness (Hounsfield units) and exact location of the stone. The treatment plan is usually based on the CT results.
Urine and Blood Tests: These are used to check for infection and kidney function.

Kidney Stone Treatment Methods

The treatment approach varies depending on the size (mm) and location of the stone, as well as the patient’s symptoms.

A. Conservative Treatment (Allowing the Stone to Pass Naturally)

Approximately 80-90% of stones measuring 5 mm or smaller may pass on their own. During this process, your doctor may recommend the following:

Drink plenty of fluids: Drinking 2.5-3 litres of water per day increases urine flow, helping to push the stone out.

Medical treatment (alpha blockers): Medication that widens the urinary tract, making it easier for the stone to pass.

Painkillers: To make the process more comfortable.

B. ESWL (Extracorporeal Shock Wave Lithotripsy)

It is not a surgical procedure. Sound waves sent from outside the body are focused on the stone and break it down into sand.

Who is it suitable for? Generally for stones smaller than 2 cm and located in suitable areas of the kidney.

Advantage: Does not require anaesthesia (or only mild sedation), no hospital stay is required.

Disadvantage: May be unsuccessful with hard stones, pain may occur while passing the sand after the procedure.

C. Ureteroscopy (URS) and Laser Lithotripsy

It is used for stones that have fallen into or are stuck in the urinary tract (ureter).

How is it done? A very thin, lighted instrument (ureteroscope) is inserted through the urethra. No incision is made. When the stone is located, it is broken up with a laser.

Advantages: High success rate, possibility of discharge on the same day.

D. RIRS (Flexible Ureteroscopy) – Retrograde Intrarenal Surgery

It is the most popular and modern treatment available today.

Method: A very thin, flexible telescope is inserted through the urinary tract to reach the deepest chambers of the kidney. The stone is completely pulverised using a Holmium or Thulium laser.

Who is it for? It is suitable for kidney stones up to 2-3 cm in size, patients using blood thinners, or those with anatomical abnormalities.

Advantages:

There are no incision marks on the body.

The risk of bleeding is very low.

The patient returns to their normal life the next day.

The success rate is over 95%.

E. PNL (Percutaneous Nephrolithotomy) – Minimally Invasive Kidney Stone Surgery

It is used for very large stones (over 2 cm) or stones that completely fill the kidney (staghorn calculi).

Method: A small 1 cm incision is made in the patient’s back, allowing direct access to the kidney, where the stones are broken up and removed.

Advantage: It allows large stones to be removed in a single session. Recovery is much faster than with open surgery.

Natural Methods and Nutrition: What Helps Kidney Stones?

The answer to the frequently asked question, ‘What is good for kidney stones?’ is supportive of treatment but cannot eliminate large stones on its own.

Lemon Juice: The citrate it contains helps prevent the formation of calcium stones.
Gilaburu Juice: There are observations that this fruit, which grows particularly in the Kayseri region, widens the kidney channels and facilitates the passing of stones.
Apple Cider Vinegar: Its acidic structure can slow down the stone formation process.
Exercise: Jumping rope or running helps small stones in motion to fall due to the effect of gravity.

Warning: The belief that ‘drinking beer helps pass kidney stones’ is not entirely medically accurate. Beer is a diuretic, but due to its oxalate and alcohol content, it can cause the body to lose water (dehydration), which is harmful in the long term. Water is always the best remedy.

How can we prevent it from happening again?

A person who has passed a kidney stone has a 50% risk of developing another stone within 5 years if no preventive measures are taken. To reduce this risk to near zero:

Water, Water, Water: Your urine should always be pale yellow or clear. Drink enough fluids to produce at least 2.5 litres of urine per day.

Reduce Salt: Salt triggers stone formation by increasing calcium excretion in urine.

Balance Animal Protein: Excessive red meat consumption paves the way for uric acid stones.

Do Not Cut Out Calcium: It is wrong to completely cut out calcium sources such as milk and yoghurt. On the contrary, calcium prevents stone formation by binding oxalate in the intestines. Consume it in moderation.