Not all kidney stones need treatment. If a stone is causing no symptoms, is not having any effect on the urinary tract, and is not likely to cause problems in the future, it may be left untreated and followed for future changes. If a stone is causing no symptoms and is small enough to probably pass spontaneously if it moves, it may be safely observed and not treated. Most stones measuring 5 millimeters (1/5th inch) or less fit in this category. If a stone is causing symptoms but is small enough to probably pass soon, conservative observation is indicated.
If a small stone is causing symptoms and is not making progress toward passing over a period of time, treatment is indicated.
Stones in the urinary tract causing pain, obstruction, infection, or visible blood in the urine should be treated (unless the stone will pass spontaneously soon). If a stone is being followed conservatively for growth, and the size reaches 5 millimeters or greater, treatment is indicated. Some jobs require the worker to be free of stones (e.g., airline pilots), and some people travel to or live in remote areas where there is scarce medical care. Stones in these patients should be treated.
There are several reasons why lithotripsy may not be safe or indicated.
- It is not safe to the fetus to treat a pregnant woman.
- Patient size and stone location affect whether or not a stone can be treated by lithotripsy. Some patients may be too large to be effectively treated.
- Stones must be within range and visible for successful ESWL.
- Blood clotting must be normal at the time of treatment.
- Please carefully read the medication and dietary supplement list here. Please review any intake with your referring physician.