Kidney stones: what to expect during diagnosis and treatment

Written by: Mr Haider Syed
Edited by: Emma McLeod

Kidney stones, while often harmless, can be painful, uncomfortable and problematic. When this happens, you’ll likely feel pain among other symptoms (see Mr Syed’s article Kidney stones: what are they and what are the symptoms?). You'll require medical help to confirm a diagnosis and, if necessary, non-surgical or surgical treatment. Mr Haider Syed, a consultant urologist and specialist in the treatment and removal of kidney stones, provides you with what you can expect.

A 3D diagram that shows the interior of a kidney

What tests can patients expect?

If you’re experiencing the symptoms of kidney stones and need to undergo testing, your examination is likely to include at least one or several the following:


Computerised Tomography (CT scan)

A CT scan is one of the most helpful methods for diagnosing kidney stones. With a CT scan, we can discover the size and position of a kidney stone, as well as how many you have and the level of obstruction that it’s causing. The scan does involve a small dose of radiation, but this is safe for the majority of patients.

With all this information, we can plan further management of your condition and decide the best course of action for treating your kidney stone(s).


Ultrasound scan

An ultrasound scan, just like a CT scan, can detect kidney stones. However, an ultrasound may miss some smaller stones in the kidney or ureter.


The benefit is that during an ultrasound, patients aren’t exposed to radiation, making it suitable for children, young women or pregnant women.


Plain X-Ray (KUB)

A plain x-ray is a basic imaging technique and it helps to identify the kidney stone and assists with following up patients’ progress after treatment.


Urine and blood tests

To determine your diagnosis, you might need to undergo baseline urine tests to rule out any infection. You might also require a urea and electrolyte blood test to define your kidney function as well as calcium and uric acid levels (the substances that can cause a kidney stone). A blood test can check your white cell count, which, if raised, signals an infection.


When is best to seek medical help?

If you suddenly develop a severe flank pain that radiates to the grown, along with nausea, vomiting and high temperature, go to your nearest accident and emergency department as soon as possible.


You’ll then be assessed and given pain relief in the form of an injection, tablet or rectal suppository. You’ll then undergo the tests that were previously mentioned: urine test, blood test and imaging tests to rule out obstructions caused by the kidney stones.


What treatment is offered for small stones?

If the stone is 4mm or less and your urine and blood results are normal, the stone is likely able to flow out the body naturally with urine. In these cases, treatment is mainly conservative (non-surgical) and for relief. You might be sent home with oral pain relief medication and have a follow-up scheduled in a clinic to review if your condition has been resolved.


What treatment is offered for large stones?

If the stone is bigger than 5mm and has led to the obstruction of your kidney, you’ll be admitted to hospital. Depending on your condition, you will have the obstruction treated urgently or you’ll be booked in for an elective procedure.


The majority of small stones within the kidney are fragmented by lithotripsy (shock wave therapy). Read Mr Syed’s in-depth explanation of lithotripsy from initial consultation to the procedure, aftercare and follow up checks).


However, a proportion of smaller stones and most larger stones need other treatment methods using telescopes passed through the bladder or through a keyhole operation. You may be offered laser surgery,  cystoscopy or a ureteroscopy.


Which treatment is best?

To know which procedure is best for you, you’ll need personalised guidance from your urologist. The decision of which procedure is best for you is taken based on the size of your stone, its position and the structure of your kidney.


Mr Haider Syed has spent many years providing patients with solutions to their kidney stones – visit his profile to get in touch and learn how he can help you.

By Mr Haider Syed

Mr Haider Syed is a senior consultant urological surgeon with over 30 years of urology experience. He is a kidney stone specialist and offers laser treatment and ESWL shockwave therapy. He additionally provides a specialist service for prostate enlargement, PSA and related prostate problems. Mr Syed also has a fast-track clinic for haematuria (blood in urine) and offers surgical treatment for adult circumcision and scrotal conditions such as epididymal cyst, hydrocele and varicocele. He also sees all patients with urinary tract infections.

Mr Syed graduated as a doctor in 1984 and completed his urology specialist training at John Radcliffe and Churchill Hospital, Oxford in 2000. He worked in the NHS for over 32 years and since retirement now works privately at Spire Little Aston Hospital. Mr Syed received his FRCS in Surgery from the Royal College of Surgeons, Ireland in 1990. He then completed a one year diploma in urology at the Institute of Urology, University College London in 1993. He completed his MSc in Urology at the Institute of Urology, University College London from 1996 to 1998. Mr Syed passed his FRCS urology specialist exam in 1999. He passed FEBU, Fellowship of the European Board of Urology in 2001. He has been a regional and national urology trainer accredited by the General Medical Council. Mr Syed is also an examiner for FRCS urology revision courses.   
Mr Syed is a firm believer that quality and provision of medical service depends upon good teamwork. He has an excellent and experienced team consisting of interventional radiologists, anaesthetists and specialist nursing staff and support teams.  
Mr Syed has presented his work at conferences of the British Association of Urological Surgeons and European Urology and World Endourology meetings. His research work has been published in the British Journal of Urology and the Journal of Endourology.
Mr Syed has recently received colleague and patient feedback as a part of 360 degree revalidation, conducted independently by Spire Healthcare in September 2022.  All feedback received was excellent from patients who were treated under my care at Little Aston Hospital.
Mr Syed has clinics on Tuesday, Wednesday and Saturday mornings. 

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