Causes, symptoms and the latest laser treatment of kidney stones

Kidney stones are hard, crystalline deposits that form inside the kidneys when certain minerals and salts in urine become concentrated. They can vary in size from tiny grains to larger stones that may block the urinary tract. Advances in treatment, including minimally invasive laser surgery, have improved outcomes and reduced recovery time for patients.

What causes kidney stones to form?

Kidney stones develop when there is an imbalance in the substances that make up urine, such as calcium, oxalate and uric acid. When these substances become too concentrated, they can form crystals that gradually grow into stones.

Risk factors include:

Not drinking enough fluids
High salt or protein diet
Obesity
A family history of kidney stones
Certain medical conditions (e.g. hyperparathyroidism, inflammatory bowel disease)
Some medications and supplements

What are the common symptoms of kidney stones?

Kidney stones can cause a range of symptoms depending on their size and location. Some people may not notice small stones that pass on their own, while others may experience severe pain.

Symptoms can include:

Intense pain in the side, back or lower abdomen
Pain that radiates to the groin
Blood in the urine (haematuria)
Frequent or painful urination
Nausea and vomiting
Fever or chills (if an infection is present)

If a stone obstructs the flow of urine or causes infection, it requires urgent medical attention.

How are kidney stones diagnosed?

Diagnosis usually begins with a physical examination and a review of symptoms. Imaging tests help confirm the presence and location of stones:

CT scan: The most sensitive method for detecting stones of all sizes
Ultrasound: Often used as a first-line test, particularly in younger patients or during pregnancy
X-ray (KUB): Can detect some types of stones but may miss others
Urine and blood tests: Used to identify possible underlying causes

What are the treatment options for kidney stones?

Treatment depends on the stone’s size, type and location, as well as the patient’s symptoms. Small stones often pass on their own with increased fluid intake and pain relief. Larger or obstructive stones may require intervention.

Options include:

Conservative management: Encouraging fluid intake and using medications to ease pain or help stone passage
Extracorporeal shock wave lithotripsy (ESWL): Uses sound waves to break stones into smaller fragments
Ureteroscopy with laser lithotripsy: Involves passing a thin scope through the urinary tract to reach the stone, then using a laser to break it up

What is laser lithotripsy and how does it work?

Laser lithotripsy is one of the most advanced and commonly used methods for treating kidney stones that do not pass naturally. The procedure involves:

Inserting a flexible ureteroscope through the bladder and up into the ureter or kidney
Using a laser (typically holmium or thulium fibre laser) to fragment the stone into fine dust
Removing or allowing the fragments to pass naturally through the urine

This minimally invasive technique typically requires no incisions, offers faster recovery, and is suitable for stones in various locations.