Hearing the words “you have a kidney stone” can feel overwhelming. The pain is often sudden, sharp, and intense, and you may be wondering what comes next. Fortunately, treatment options are available, and your care team will help you decide on the best approach depending on the size, location, and type of stone. Here’s what you can expect after a kidney stone diagnosis.
Step 1: Immediate Relief and Assessment
If you’ve come to the emergency department or your doctor’s office with severe flank pain, the first step is usually pain control and imaging. A CT scan or ultrasound confirms the stone’s size and position in your urinary tract. Blood and urine tests may also be ordered to check kidney function and rule out infection.
At this stage, your provider will determine whether the stone has a chance of passing on its own. Very small stones (typically less than 5 millimeters) often pass naturally with fluids and medication. Larger stones, or stones causing persistent pain, obstruction, or infection, usually require a procedure.
Step 2: Surgery vs. Lithotripsy
If you need an intervention, you may be given two main options:
- Surgery (Ureteroscopy or Percutaneous Nephrolithotomy):
In many cases, surgery can be scheduled quickly—sometimes the same day if your pain is uncontrollable or the stone is blocking your kidney. Ureteroscopy involves a small camera passed through the urinary tract to locate and remove or break apart the stone. Larger or more complex stones may require a minimally invasive incision in the back (percutaneous nephrolithotomy). Surgery is effective and often provides immediate relief. However, it usually requires anesthesia, a stent placement (which needs to later be removed), a short hospital stay, and a longer recovery period compared to other treatments.
- Extracorporeal Shock Wave Lithotripsy (ESWL or “litho”):
Lithotripsy uses sound waves directed from outside the body to break the stone into smaller pieces that can pass naturally. This option is less invasive than surgery and typically comes with a faster, easier recovery. Most people can go home the same day and resume normal activities within a day or two. However, lithotripsy isn’t always performed immediately. Depending on your hospital or urology clinic, you may need to wait several days to schedule the procedure. Additionally, not all stones are good candidates—very large, very dense, or poorly positioned stones may not respond well to shock waves.
Step 3: Why Waiting Can Be Worth It
If your stone qualifies for lithotripsy and your condition is stable (meaning no infection or complete obstruction), your doctor may recommend waiting a few days for the procedure rather than going straight to surgery. Here’s why:
- Less invasive: No scopes or incisions are required.
- Quicker recovery: Most people return to daily routines within 24-48 hours.
- Lower complication risk: Reduced chance of infection, scarring, or ureteral injury compared to surgery.
- Repeatable if needed: Lithotripsy can be performed more than once if fragments remain.
Step 4: Recovery and Follow-Up
Whether you undergo surgery or lithotripsy, you’ll have follow-up imaging to ensure the stone has been fully removed or passed. Your doctor may also run tests to determine the stone’s composition, which helps guide prevention strategies. Recommendations often include:
- Drinking more water to stay well-hydrated
- Adjusting your diet (such as lowering salt or certain animal proteins)
- Taking medications to reduce stone-forming minerals if needed
The Bottom Line
A kidney stone diagnosis can be daunting, but you’re not without options. Immediate surgery offers fast relief when urgent intervention is needed, while lithotripsy provides a less invasive alternative with a smoother recovery, though it may require a short wait. Working with your urologist, you’ll develop a treatment plan tailored to your stone and your lifestyle, with the ultimate goal of getting you back to feeling well and preventing future stones.