Kidney Stone Treatment in Kuala Lumpur
Kidney stones may cause pain, bleeding, infection, or blockage of urine flow.
Treatment depends on the stone size, location, symptoms, kidney function, and infection risk.
Overview
Kidney stones are hard deposits that form in the kidney when minerals and salts in the urine become concentrated and crystallise. Some stones are small and may pass naturally, while others can cause pain, bleeding, infection, or blockage of urine flow.
This page explains how kidney stones are assessed, when treatment may be needed, and the main treatment options available. The most suitable approach depends on the stone size, location, symptoms, kidney function, infection risk, and overall health.
What Are Kidney Stones?
Kidney stones may form when the urine contains high levels of stone-forming substances such as calcium, oxalate, uric acid, or cystine, or when there is not enough fluid in the urine to keep these substances diluted.
Common risk factors include:
- Not drinking enough fluid
- Recurrent dehydration
- High salt intake
- High intake of animal protein
- Family history of kidney stones
- Recurrent urinary tract infections
- Gout or high uric acid levels
- Certain metabolic or hormonal conditions
- Previous history of kidney stones
Kidney stones can recur, so treatment should not only focus on removing the stone, but also on reducing the chance of future stones.
Symptoms of Kidney Stones
Some kidney stones cause no symptoms and are found during scans for another reason. Others may move into the ureter, the tube between the kidney and bladder, and cause blockage.
Symptoms may include:
- Sudden pain in the back or side
- Pain spreading to the lower abdomen or groin
- Blood in the urine
- Nausea or vomiting
- Pain or burning when passing urine
- Frequent or urgent urination
- Cloudy or foul-smelling urine
- Fever or chills if infection is present
Fever, chills, severe pain, vomiting, or difficulty passing urine should be assessed urgently, especially if a stone is causing obstruction.
How Kidney Stones Are Diagnosed
Assessment usually aims to confirm the presence of a stone, identify its size and location, and check whether it is affecting kidney function or causing infection.
Tests may include:
- Urine tests to look for blood, infection, or crystals
- Blood tests to assess kidney function, infection markers, calcium, uric acid, and other metabolic factors
- Ultrasound KUB to assess the kidneys, ureters, and bladder without radiation
- X-ray KUB for selected stones that are visible on X-ray
- Non-contrast CT KUB, which is commonly used to define the size, number, and location of stones more accurately
For recurrent stones, further metabolic assessment may be recommended to identify preventable causes.
When Treatment May Be Needed
Not every kidney stone requires surgery. Some small stones may pass naturally with pain control, hydration, and monitoring.
Treatment may be considered if:
- The stone is unlikely to pass on its own
- Pain is severe or persistent
- The stone is causing blockage
- There is infection together with obstruction
- Kidney function is affected
- The stone is increasing in size
- There are recurrent stone episodes
- The stone is large, complex, or located in a difficult position
The decision is usually based on balancing the likelihood of natural passage against the risk of ongoing symptoms, obstruction, infection, or kidney damage.
Kidney Stone Treatment Options
Treatment is individualised according to the stoneās size, location, density, anatomy, symptoms, and patient factors.
Conservative Management
Small stones, especially those in the ureter, may pass without surgery. Management may include pain relief, hydration advice, medication to help stone passage in selected cases, and follow-up imaging.
This approach is usually only suitable when symptoms are controlled, there is no infection, and kidney function is not at risk.
Extracorporeal Shock Wave Lithotripsy
Extracorporeal shock wave lithotripsy, or ESWL, uses shock waves from outside the body to break selected stones into smaller fragments that can pass in the urine.
It may be suitable for certain smaller kidney or upper ureteric stones, depending on stone size, position, density, and body habitus. Some patients may need more than one session.
Ureteroscopy and Laser Lithotripsy
Ureteroscopy involves passing a small telescope through the urinary passage into the ureter or kidney. A laser can then be used to fragment or dust the stone.
This is commonly used for ureteric stones and selected kidney stones. A temporary ureteric stent may sometimes be placed after the procedure to support drainage while swelling settles.
Retrograde Intrarenal Surgery
Retrograde intrarenal surgery, or RIRS, uses a flexible ureteroscope to reach stones inside the kidney through the natural urinary passage. Laser energy is used to break the stone into smaller fragments or dust.
RIRS may be considered for selected kidney stones, especially when a less invasive internal approach is suitable.
Percutaneous Nephrolithotomy
Percutaneous nephrolithotomy, or PCNL, is a keyhole procedure used for larger or more complex kidney stones. The kidney is accessed through a small incision in the back, allowing instruments to break and remove stone material directly.
Mini-PCNL uses a smaller access tract and may be suitable for selected stones where direct kidney access is needed but a smaller tract is appropriate.
Ureteric Stent Placement
A ureteric stent is a thin, flexible tube placed between the kidney and bladder to help urine drain. It may be used when a stone is causing blockage, when drainage is needed before or after stone treatment, or after certain procedures to allow the ureter to settle.
Stents are usually temporary. Some people may notice urinary frequency, urgency, mild discomfort, or blood-stained urine while the stent is in place. These symptoms often improve after the stent is removed, and the expected duration of stenting will usually be discussed before or after the procedure.
Choosing the Right Treatment
There is no single best treatment for every kidney stone. The most appropriate option depends on several factors, including:
- Stone size
- Stone location
- Stone density
- Number of stones
- Presence of infection
- Degree of blockage
- Kidney function
- Previous stone history
- Patient anatomy and overall health
- Preference after counselling
A careful review of imaging and symptoms is important before deciding whether observation, ESWL, ureteroscopy, RIRS, PCNL, mini-PCNL, or stenting is most appropriate.
Stone Analysis and Prevention
After a stone is passed or removed, stone analysis may help identify its composition. This can guide prevention strategies, especially for people with recurrent stones.
Prevention may include:
- Drinking enough fluid to keep urine diluted
- Reducing salt intake
- Avoiding excessive animal protein
- Maintaining normal dietary calcium rather than avoiding calcium completely
- Adjusting oxalate-rich foods if appropriate
- Treating high uric acid or other metabolic causes
- Follow-up urine, blood, or imaging tests when needed
Prevention advice should be individualised, as different stone types may require different strategies.
When to Seek Urgent Medical Attention
Seek urgent assessment if kidney stone symptoms are associated with:
- Fever or chills
- Severe pain that does not improve
- Persistent vomiting
- Difficulty passing urine
- Known single kidney
- Pregnancy
- Signs of infection
- Reduced kidney function
A blocked infected kidney can become serious and may require urgent drainage.
Discussing Your Kidney Stone Treatment Options
The most suitable treatment for a kidney stone depends on the stone size, location, symptoms, kidney function, and whether there are signs of infection or blockage.
A urology consultation may help clarify whether the stone can be monitored, whether treatment is needed, and which option is most appropriate based on the imaging findings and overall clinical picture.
Appointments with Dr Roger Anthony Idi are arranged through Prince Court Medical Centre.