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What are my treatment options for kidney stones?

Hi. Male 37 yrs old/Chinese. About 7 weeks ago, I awoke to sharp pains in my lower stomach/groin area. The pain was quite intense and I had cold sweats. After making my way to the polyclinic, the pain started to subside around and the doctor didn't find anything wrong. About 4 weeks ago, I experienced the same pain again. I also observed pink urine (blood in urine). I went back to the polyclinic and the doctor arranged for an ultrasound for my kidneys. The ultrasound nurse noticed a rice sized particle in my right kidney. I am particularly concerned about kidney stones. What should I do next, and what are my treatment options for kidney stones? Kindly advise, thank you. 

Hi, in Singapore, the specialist that deals with kidney stones most frequently is a urologist, so you may want to get a referral letter from your GP/polyclinic.

About 12 percent of all people will have kidney stones at some point in their lives. Small stones are usually passed during urination, but larger ones can block your ureter (ie tubes which carry urine from your kidneys). 

Kidney stones can either be:

1) obstructing or 

2) non-obstructing. 

Obstructing kidney stones are larger (greater than 7 mm) and tend to block your urinary tract.

Non-obstructive kidney stones (smaller than 7 mm) usually pass on their own.

Imaging tests, such as X-Rays, Ultrasound, and CT scans are very useful for pinpointing the exact location and size of the stone.  

For non-obstructing stones, your doctor will advise you to drink a lot of water while providing you painkillers to help with the pain. Waiting 2 - 4 weeks for a stone to pass is reasonable. Your doctor may also prescribe tamsulosin, a medication that relaxes the muscles of your ureter. Relaxing the ureter may help a smaller kidney stone to pass, and can relieve discomfort.  

For larger obstructing stones, the following interventions may be offered:

1) Extracorporeal shock wave lithotripsy (ESWL). This is the most commonly offered treatment that involves using a machine (that relies on high energy sound waves) to break up a stone from outside of your body, allowing you to pass the stone more easily. 

2) Percutaneous nephrolithotomy (PCNL) involves inserting a tube through a small cut to help remove the stone.

3) A ureteroscope (a small, tube-like instrument equipped with a camera) can be inserted into your penis urethra to either manually extract the stone or break it into tiny pieces.

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