Kidney Stones Treatment in Indore

Kidney stones are hard crystalline deposits that form in the urinary tract when urine becomes concentrated and salts crystallise. Central India, including Indore, lies within the region often described as the stone belt, where hot weather, high sweat losses and inadequate water intake combine to make stone disease particularly common. Renal colic is widely described as one of the most severe pains in medicine.

Types of Kidney Stones

1. Calcium oxalate: The commonest type, accounting for the majority of stones.
2. Calcium phosphate: Often associated with renal tubular acidosis.
3. Uric acid: Radiolucent, so not visible on plain X-ray, and associated with gout, obesity and high purine intake.
4. Struvite (infection stones): Formed in the presence of urinary infection, can grow large and fill the collecting system as staghorn calculi.
5. Cystine: Rare, hereditary, and typically presenting in childhood or early adulthood with recurrent stones.

Causes and Risk Factors

1. Inadequate fluid intake, the single biggest modifiable factor
2. Hot climate and occupational heat exposure with high insensible losses
3. High salt, high animal protein and high oxalate diet
4. Obesity, diabetes and metabolic syndrome
5. Family history, which roughly doubles the risk
6. Recurrent urinary tract infection
7. Hyperparathyroidism, gout and inflammatory bowel disease
8. Certain medications and excessive calcium or vitamin D supplementation

Symptoms of Kidney Stones

1. Severe colicky pain starting in the flank and radiating to the groin, coming in waves
2. Restlessness and inability to find a comfortable position, which distinguishes it from peritonitis where patients lie still
3. Nausea and vomiting
4. Blood in the urine, visible or microscopic
5. Burning urination, urgency and frequency when the stone reaches the lower ureter
6. Fever with chills, which indicates infection behind an obstructing stone and is a urological emergency
7. Sometimes completely silent, with large stones found incidentally on scanning

When to See a Doctor

Seek emergency care for severe pain with fever and chills, for inability to pass urine, for uncontrolled vomiting, or if you have a single functioning kidney. Fever with an obstructed kidney is a genuine emergency requiring urgent drainage, as infection behind an obstruction can progress to sepsis within hours. See a urologist for any confirmed stone, even if the pain has settled, since a stone that has stopped hurting has not necessarily passed.

Treatment for Kidney Stones

1. Diagnosis: Non-contrast CT of the kidneys, ureters and bladder is the gold standard; ultrasound is used in pregnancy and for follow-up.
2. Conservative management: Stones under 5 mm frequently pass spontaneously with high fluid intake, analgesia and medical expulsive therapy using alpha blockers.
3. ESWL (shock wave lithotripsy): Non-invasive fragmentation of suitable renal stones using externally focused shock waves.
4. URSL and RIRS: Endoscopic laser fragmentation of ureteric and renal stones through the natural urinary passage, with no external incision.
5. PCNL: Keyhole access through the flank for large or staghorn renal stones.
6. Emergency drainage: DJ stenting or percutaneous nephrostomy for an infected, obstructed kidney, before definitive stone treatment.
7. Metabolic evaluation and prevention: Stone analysis, 24-hour urine studies and serum calcium, uric acid and parathyroid assessment in recurrent stone formers. Our urology team manages both the stone and the prevention plan.

What Happens If You Delay Treatment

This is the most important point about stone disease, and the least understood. A stone obstructing the ureter can silently destroy the kidney behind it. Pressure builds, the kidney swells, and after several weeks of unrelieved obstruction that kidney loses function permanently, often without any pain once the initial colic has settled. Patients regularly present having ignored a stone for months because “the pain stopped”, only to find the kidney is no longer working. Add infection to an obstruction and the situation becomes life-threatening within hours. Any confirmed stone needs a plan, whether that plan is watchful waiting or intervention.