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Kidney Stones

Expert diagnosis and treatment of kidney stones in Wrexham, Chester and Shrewsbury

Kidney stones are hard deposits that form when minerals and salts in the urine crystallise. They can remain within the kidney without causing symptoms or travel into the ureter, the tube connecting the kidney to the bladder.

A stone can cause anything from mild discomfort to severe, sudden pain. Some stones pass naturally, while others become stuck and require treatment.

As a Consultant Urological Surgeon specialising in endourology, I provide specialist assessment and treatment for kidney stones and ureteric stones in Wrexham, Chester and Shrewsbury, including modern minimally invasive and laser techniques.

What are kidney stones?

Kidney stones form when substances within the urine become concentrated and crystallise.

Stones can vary considerably in:

  • Size

  • Location

  • Composition

  • Shape

Small stones may pass naturally through the urinary tract. Larger stones may remain within the kidney or become lodged in the ureter, causing obstruction and pain.

Some people develop kidney stones only once, while others experience recurrent stones.

What are the symptoms of kidney stones?

The symptoms depend largely on the size and location of the stone.

Common symptoms include:

  • Severe pain in the side or back

  • Pain that radiates towards the abdomen or groin

  • Pain that comes and goes in waves

  • Nausea or vomiting

  • Blood in the urine

  • Burning or discomfort when passing urine

  • Increased urinary frequency or urgency

  • Difficulty passing urine

Some kidney stones cause no symptoms at all and are discovered incidentally during an ultrasound, CT scan or other investigation.

What does kidney stone pain feel like?

Pain caused by a stone moving through the ureter is often called renal or ureteric colic.

It can be severe and may:

  • Start suddenly

  • Come in waves

  • Move from the back or side towards the groin

  • Be associated with nausea or vomiting

Unlike many other causes of back pain, people with renal colic often find it difficult to get comfortable or remain still.

However, not every patient with a kidney stone experiences severe pain.

When is a kidney stone an emergency?

Most kidney stones are not immediately dangerous, but a blocked kidney combined with infection can be a medical emergency.

Seek urgent medical attention if you have a suspected kidney stone together with:

  • Fever or shaking chills

  • Feeling significantly unwell

  • Persistent vomiting

  • Severe or worsening pain

  • Difficulty passing urine

  • A single functioning kidney

  • Known kidney disease

An infected and obstructed kidney may require urgent drainage before definitive stone treatment.

How are kidney stones diagnosed?

The appropriate investigation depends on your symptoms and circumstances.

Urine tests

A urine test can look for:

  • Blood

  • Infection

  • Other abnormalities

A urine culture may be required if infection is suspected.

Blood tests

Blood tests may assess:

  • Kidney function

  • Evidence of infection

  • Calcium levels

  • Other factors that may contribute to stone formation

Ultrasound

An ultrasound scan can identify many kidney stones and can also show whether the urinary tract is dilated as a result of obstruction.

However, small ureteric stones can sometimes be difficult to see on ultrasound.

CT scan

A non-contrast CT scan of the urinary tract, often called a CT KUB, is commonly used when a precise diagnosis is required.

CT can provide detailed information about:

  • Stone size

  • Stone location

  • Number of stones

  • Degree of obstruction

  • The anatomy of the urinary tract

This information can be particularly useful when deciding whether treatment is required.

Will my kidney stone pass naturally?

Some stones can pass without an operation.

The likelihood of spontaneous passage depends on factors including:

  • Stone size

  • Stone location

  • Shape of the stone

  • Degree of obstruction

  • Individual anatomy

Smaller stones, particularly those already close to the bladder, are generally more likely to pass than larger stones located higher in the ureter.

If a stone is likely to pass safely, observation with appropriate pain relief and follow-up may be recommended.

Kidney stone treatment options

There is no single treatment that is appropriate for every stone.

Treatment depends on the size, location and composition of the stone, whether it is causing symptoms or obstruction, whether there is infection, and your individual circumstances.

Observation

Small, uncomplicated stones may be monitored while waiting for spontaneous passage.

You may be advised to drink an appropriate amount of fluid and use pain relief if necessary.

Follow-up imaging may be required to confirm whether the stone has passed.

Medical expulsive therapy

In selected patients with a ureteric stone, medication such as an alpha blocker may sometimes be considered to help facilitate stone passage.

This is not appropriate for every stone, and the decision depends on its size, location and your clinical circumstances.

Shockwave lithotripsy (SWL)

Shockwave lithotripsy uses externally generated shockwaves to break a stone into smaller fragments.

The fragments can then pass naturally through the urinary tract.

SWL can be an effective treatment for appropriately selected kidney and ureteric stones. Its suitability depends on factors including stone size, location, composition and body anatomy

Ureteroscopy and laser stone treatment

Ureteroscopy is a minimally invasive procedure in which a small telescope is passed through the natural urinary passage into the bladder and then into the ureter or kidney.

A laser can then be used to fragment the stone into smaller pieces or dust.

The stone fragments can be removed using specialised instruments, and a temporary ureteric stent may sometimes be required.

Ureteroscopy can treat stones in different parts of the urinary tract and avoids an external incision.

Percutaneous nephrolithotomy (PCNL)

For larger or more complex kidney stones, percutaneous nephrolithotomy (PCNL) may be recommended.

A small tract is created directly into the kidney through the skin, allowing instruments to be introduced to remove or fragment the stone.

PCNL is particularly useful for large stone burdens and certain complex kidney stones.

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Learn more about Ureteroscopy and Keyhole stone surgery

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What happens after kidney stone treatment?

After treatment, follow-up depends on the type and size of the stone and the treatment performed.

Follow-up may include:

  • Urine testing

  • Blood tests

  • Imaging

  • Confirmation that the kidney is draining normally

  • Removal of a temporary ureteric stent where required

  • Stone analysis

The aim is not only to treat the current stone but, where possible, to understand why it formed and reduce the risk of future stones.

When should a kidney stone be treated?

Treatment may be recommended when a stone:

The decision should take into account both the medical circumstances and your preferences.

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