In March 2026, We performed 80 endometriosis surgeries. learn more > We performed 80 endometriosis surgeries. In March 2026, We performed 80 endometriosis surgeries. learn more >

Home > Urology > Kidney Stones

Kidney Stones

Renal colic has been described as the closest pain a man will experience to childbirth. That is not an exaggeration - it is a clinical observation. Kidney stones cause one of the most severe pain presentations in emergency medicine, and they recur in nearly 50% of patients within five years without proper prevention.

At Shree Hospitals, our kidney stone treatment in Mumbai addresses both problems: removing the stone that is causing the problem now and identifying why it formed to prevent the next one. Our urology and nephrology team works together to cover every aspect - from emergency pain management to stone analysis, metabolic workup, and long-term dietary and pharmacological prevention.

(24×7 Emergency Care)

1800-268-4000

(24×7 Emergency Care)

1800-268-4000

Our Approach in Managing Kidney Stones

Managing a kidney stone patient is a two-phase challenge. In the acute phase, the priority is pain, obstruction, and infection. Once the stone is dealt with, the metabolic workup begins, because a stone that formed once has a 50% chance of forming again if nothing changes.

Our urolithiasis specialist team in Mumbai, India is structured to handle both phases as a continuum, not as two separate events with a gap in between.

Acute Assessment & Imaging

Non-contrast CT KUB (kidneys, ureters, bladder) - gold standard imaging; detects stones as small as 1mm, assesses size and location
Ultrasound KUB - first-line where radiation avoidance is preferred (pregnancy, children, radiation-sensitive patients); less sensitive for ureteric stones
Plain X-ray KUB - useful only for radio-opaque stones (calcium oxalate, calcium phosphate); misses uric acid and cystine stones
Assessment of obstruction - degree of hydronephrosis, contralateral kidney, signs of infected obstructed kidney (a urological emergency)

Acute Pain Management

Renal colic pain requires prompt and effective management - under-treatment is not appropriate.

NSAIDs (Diclofenac, Ketorolac) - first-line; reduces ureteric spasm and inflammation
Antispasmodics - adjunct for ureteric relaxation
Opioid analgesia for severe or NSAID-refractory pain
IV fluids for hydration - does not force stone passage but prevents volume depletion from vomiting

Conservative Management - Watchful Waiting with Medical Expulsion

Stones ≤5mm: 80% pass spontaneously. Stones 5–10mm: 50% pass with medical therapy.

Alpha-blockers (Tamsulosin) - ureteric smooth muscle relaxation; significantly improves passage rates for distal ureteric stones
PDE5 inhibitors - emerging evidence for adjunct use in medical expulsion therapy
Adequate hydration - 2.5–3 litres per day
Pain control and outpatient monitoring with repeat imaging at 4 weeks

Interventional Stone Removal

ESWL for stones (Extracorporeal Shock Wave Lithotripsy) - non-invasive; shock waves fragment stones externally; most effective for renal stones <2cm and selected upper ureteric stones
Ureteroscopy (URS) with laser lithotripsy - flexible or rigid ureteroscope; highly effective for ureteric stones of any size; day procedure under general anaesthesia
Percutaneous Nephrolithotomy (PCNL) - for large renal stones (>2cm), staghorn calculi; access through the skin directly into the kidney
Mini-PCNL and ultra-mini-PCNL - reduced-access variants for smaller stones with faster recovery

Infected Obstructed Kidney - Emergency Management

This is the scenario that kills. An obstructed kidney with infection is a urological emergency.

Signs: fever, rigors, flank pain in the context of a known or suspected stone
Emergency ureteric stenting or nephrostomy insertion to drain the infected system
IV antibiotics and resuscitation
Definitive stone treatment deferred until infection resolves

Metabolic Workup & Recurrent Stone Formation Prevention

A stone that forms once without prevention will very likely form again.

24-hour urine collection - volume, calcium, oxalate, uric acid, citrate, sodium, pH
Serum calcium, uric acid, PTH - to exclude hyperparathyroidism and hyperuricaemia
Stone analysis - composition determines prevention strategy
Calcium oxalate stones (most common): increase fluid intake, reduce dietary oxalate and sodium, potassium citrate supplementation, thiazide diuretics for hypercalciuria
Uric acid stones: urinary alkalinisation (potassium citrate), allopurinol for hyperuricosuria
Struvite/infection stones: treat underlying urease-producing organism

How to Identify Kidney Stones?

Kidney stones are identified either during an acute episode or incidentally on imaging. Both situations need follow-up.

Features that indicate a kidney stone presentation:

Sudden severe pain in the flank, back, or side, coming in waves and radiating to the groin or inner thigh - renal colic pain is the classic presentation
Blood in the urine - may be visible (pink or red urine) or detected only on dipstick
Nausea, vomiting, and inability to find a comfortable position - patients with renal colic are restless
Pain that seems to move or shift as the stone travels down the ureter
Small stones in the lower ureter produce symptoms mimicking a bladder or urethral problem - burning, urgency, frequency
Fever with any of the above - this changes the urgency to immediate emergency care

Some stones are completely silent - found on an ultrasound done for another reason. These still require assessment. Size, location, and composition determine whether they need treatment or monitoring. Do not assume a silent stone is a safe stone.

Recurrent stone formation can be prevented - but only if the first stone is properly investigated. Seek kidney stone treatment in Mumbai that includes prevention, not just removal.

Important FAQs - Kidney Stones

How long does it take to pass a kidney stone?

Stones under 5mm usually pass within 1–4 weeks with adequate hydration and medical expulsion therapy. Larger stones are unlikely to pass spontaneously and require intervention.

Is ESWL painful?

ESWL is uncomfortable rather than painful for most patients. It is performed with local anaesthesia or mild sedation. Post-procedure, patients may experience mild flank discomfort and haematuria for a few days as fragments pass.

Can kidney stones come back after treatment?

Yes - recurrence rates are approximately 50% at 5 years without preventive measures. Stone composition analysis and 24-hour urine metabolic workup allow targeted prevention that significantly reduces recurrence risk.

Do kidney stones damage the kidneys permanently?

Repeated obstruction, especially when combined with infection, can cause permanent kidney scarring. Prompt treatment and recurrence prevention protect long-term kidney function.

Can diet alone prevent kidney stones?

For some stone types - particularly uric acid stones - dietary modification (reduced purine, increased hydration, urinary alkalinisation) is highly effective. For calcium oxalate stones, diet is important but often needs pharmacological supplementation.

Treatments for Kidney Stones at Shree Hospitals

Comprehensive kidney stone removal and prevention in Mumbai from emergency pain management to metabolic prevention programmes.

ESWL (Extracorporeal Shock Wave Lithotripsy)

ESWL for stones is a non-invasive procedure using focused shock waves to fragment renal and upper ureteric stones. No incision, no anaesthesia in most cases, and day-procedure convenience.

Ureteroscopy with Laser Lithotripsy

Highly effective minimally invasive procedure using a thin ureteroscope and holmium laser to fragment and remove ureteric stones of any size. Gold standard for ureteric urolithiasis management.

Percutaneous Nephrolithotomy (PCNL)

For large renal stones and staghorn calculi. Provides direct access to the kidney through a small skin incision. Our surgical team performs mini-PCNL for reduced morbidity in appropriate patients.

Stone Prevention & Metabolic Workup

24-hour urine metabolic analysis and stone composition-guided prevention programme - dietary, pharmacological, and hydration-based strategies to eliminate recurrent stone formation.