Kidney Stones: Causes, Prevention, and Treatment, A Complete FAQ Guide
By Dr. Anup Ramani
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Kidney stones form when minerals like calcium, oxalate, and uric acid build up and crystallize in the urine. Most small stones pass on their own with adequate water intake, while larger or blocking stones often need a minimal invasive laser procedure such as URS or RIRS. Diet, hydration, and regular checkups are the main tools for preventing kidney stones from returning, and an experienced urologist can guide both treatment and long term prevention.
Introduction
Kidney stones are one of the most common urological problems, affecting millions of people every year and causing some of the sharpest pain a person can experience. Rising rates are linked to modern diets high in salt and processed food, chronic dehydration, and sedentary lifestyles, and once a person forms one stone, the chance of forming another rises sharply without proper prevention. This guide answers the questions patients search for most often about kidney stones, from diet and prevention to surgery and long term health risks, and explains where a specialist urologist and robotic surgeon such as Dr. Anup Ramani fits into the treatment journey.
Understanding Kidney Stones
What are the different types of kidney stones?
Calcium oxalate stones are the most common type and form when calcium binds with oxalate in the urine, often linked to diet and low fluid intake. Uric acid stones develop in people with high uric acid levels or chronic dehydration, struvite stones form after certain urinary infections, and cystine stones occur in a rare inherited condition. Identifying the exact stone type through laboratory analysis helps guide a more targeted prevention plan for each patient.
What symptoms suggest a kidney stone that needs medical attention?
Sudden severe pain in the back or side that moves toward the lower abdomen or groin, blood in the urine, nausea or vomiting, fever with chills, or a burning sensation while urinating are all signs that should prompt a same day evaluation. Fever alongside stone symptoms can indicate infection behind a blocked kidney, which is considered an emergency and needs urgent treatment.
Why do kidney stones keep coming back?
Kidney stones return often because the underlying cause, such as low water intake, a diet high in salt and oxalate, or an unbalanced urine chemistry, is never fully corrected. Some patients also have a metabolic tendency to form stones, meaning the body naturally concentrates certain minerals in urine. Without dietary changes and periodic checkups, roughly half of patients who form one kidney stone will form another within several years.
What is the best diet to prevent kidney stones?
A kidney stone friendly diet centers on generous water intake, moderate salt, limited animal protein, and enough dietary calcium from food rather than supplements, since dietary calcium actually binds oxalate in the gut and lowers stone risk. Citrus fruits like lemon and orange also help by increasing urinary citrate, which reduces crystal formation. The right diet depends on the stone type, so testing stone composition helps tailor these recommendations.
Which foods cause kidney stones?
Foods high in oxalate, such as spinach, beetroot, nuts, and chocolate, along with excess salt, sugary drinks, and high animal protein intake, are commonly linked to kidney stone formation. Very high vitamin C supplementation can also raise oxalate levels in some people. These foods do not need to be eliminated entirely, but moderation matters for patients prone to recurrent stones.
How much water should kidney stone patients drink?
Most urologists recommend at least two and a half to three liters of water a day for patients with a history of kidney stones, enough to keep urine pale yellow throughout the day. In hot climates or with heavy physical activity, fluid needs rise further. Spreading water intake evenly across the day, rather than drinking it all at once, gives more consistent protection against new stone formation.
How can you tell kidney stone pain from ordinary back pain?
Kidney stone pain typically starts suddenly in the back or side below the ribs and moves in waves toward the lower abdomen or groin, often with nausea, blood in urine, or an urgent need to urinate. Ordinary back pain from muscles or posture usually stays in one place, worsens with movement, and improves with rest. Severe pain that comes in cramping waves and does not ease with position changes should prompt an urgent ultrasound or CT scan.
What size of kidney stone needs surgery?
Stones under four millimeters usually pass on their own with hydration and mild pain relief, while stones between four and six millimeters may pass with medical help but often need monitoring. Stones larger than seven millimeters, stones causing blockage or infection, or stones that fail to move after several weeks generally require a surgical procedure such as URS, RIRS, or in select larger cases, PCNL.
Can kidney stones pass naturally without surgery?
Yes, small stones, particularly those under five millimeters located in the lower ureter, pass naturally in most patients within four to six weeks with good hydration, pain control, and sometimes a medication that relaxes the ureter. Regular imaging is used to confirm the stone has passed and has not caused silent damage to the kidney while waiting.
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What is the difference between laser kidney stone surgery and ESWL?
Laser kidney stone surgery, performed through procedures like URS or RIRS, uses a scope passed through the urinary tract to reach the stone directly and break it under vision, which gives high success rates even for harder stones. ESWL, or shock wave lithotripsy, breaks stones from outside the body using sound waves without any scope, but works best for smaller, softer stones and has a lower success rate for larger or harder stones. Most specialists now prefer laser based procedures for their precision and consistency.
What happens if kidney stones are not removed when needed?
An untreated obstructing kidney stone can cause the kidney to swell with trapped urine, a condition called hydronephrosis, which can gradually damage kidney function if it continues for weeks or months. Stones left in place also raise the risk of recurrent infections and, in severe cases, permanent loss of function in the affected kidney. This is why persistent or large stones should not be ignored.
How can you prevent kidney stones for life?
Long term prevention combines consistent high fluid intake, a balanced low salt diet, maintaining a healthy body weight, and treating any underlying metabolic condition that promotes stone formation. Patients who have already had one stone benefit from a urine test to identify their specific risk factors, followed by yearly imaging to catch any new stone early, before it grows or causes symptoms.
Can kidney stones cause kidney failure?
A single small stone rarely causes kidney failure, but repeated large stones, prolonged blockage, or stones affecting both kidneys at once can gradually reduce kidney function over time. Patients with recurrent stones, especially those with only one working kidney, should be monitored closely to prevent this long term risk.
Can kidney stones affect fertility?
Kidney stones themselves do not directly cause infertility, but severe infection, prolonged blockage, or damage to kidney function from repeated stones can indirectly affect overall reproductive health, and pain from stones during pregnancy needs prompt specialist care. Most patients with well managed kidney stones have no impact on their fertility at all.
Can kidney stones be prevented naturally without medication?
Yes, for many patients, adequate water intake, dietary changes, weight management, and reducing salt and animal protein are enough to significantly lower the risk of new kidney stones without any medication. Patients with a stronger metabolic tendency to form stones, however, may still need targeted medical therapy alongside these natural measures.
Can small kidney stones become large over time?
Yes, a small kidney stone can continue to grow if the underlying cause, such as concentrated urine or a metabolic imbalance, is not addressed. Regular monitoring with ultrasound allows the urology team to track stone size and intervene with a minimal invasive procedure before it grows large enough to cause blockage or severe pain.
Can kidney stones cause high blood pressure?
Kidney stones are not a direct cause of high blood pressure, but repeated kidney damage from severe or recurrent stones, or prolonged obstruction affecting kidney function, can contribute to elevated blood pressure over time. Keeping kidney function healthy through timely stone treatment helps protect against this indirect risk.
Are kidney stones more common in men or women, and can they run in families?
Kidney stones are somewhat more common in men, though rates in women have been rising with changes in diet and lifestyle. A family history of kidney stones does increase individual risk, since inherited patterns in how the body handles calcium, oxalate, and uric acid can be passed down, so people with a strong family history benefit from earlier screening and closer attention to prevention.
Can kidney stones cause a urinary tract infection, and how are the two related?
A kidney stone can trap bacteria behind it and block normal urine flow, which creates ideal conditions for infection to develop or worsen. This combination, often called an infected obstructed kidney, is considered a medical emergency because it can rapidly damage the kidney and lead to serious infection if not drained and treated quickly, usually with a temporary stent or tube followed by definitive stone removal once the infection is controlled.
How Dr. Anup Ramani Can Help with Kidney Stone Treatment
Dr. Anup Ramani is a Mumbai based urologist and robotic surgeon who treats kidney stones using advanced, minimal invasive techniques including Ureteroscopy or URS and Retrograde Intrarenal Surgery or RIRS. Both procedures use a scope passed through the natural urinary tract, so there are no external cuts, and a laser is used to break the stone under direct vision, which allows precise treatment even for stones that are difficult to reach or resistant to shock wave therapy.
Patients typically go home within a day or two, resume light activity within a week, and return to normal routines within a month. Beyond the procedure itself, his clinic focuses on identifying the underlying cause of stone formation through detailed testing, followed by a personalized diet and hydration plan aimed at preventing the next stone, rather than treating each episode in isolation. Because Dr. Ramani also specializes in complex kidney surgery, patients with unusual stone locations, very large stones, or stones alongside other kidney conditions benefit from a single specialist who can manage the full picture of kidney health rather than being referred between different doctors.
For patients dealing with recurrent kidney stones or stones that have not responded to earlier treatment, a consultation with an experienced kidney stone surgeon can help clarify the best long term plan, including whether URS, RIRS, or a combination approach is most suitable for the specific stone size, location, and composition involved.
Note: This article is for general education about kidney stones and does not replace medical advice. Please consult a qualified urologist for diagnosis and treatment specific to your condition.
About Author
Uro-Oncological & Robotic Surgeon
Dr. Anup Ramani is a robotic uro-oncological surgeon and an internationally recognized expert in robotic surgery for prostate, kidney and urinary bladder cancers. With more than two decades of robotic experience and 2,000+ robotic procedures, he brings unmatched precision and outcomes to complex uro-oncology cases. He is widely published in his field and is known for a personal, transparent approach-often spending over an hour in initial consultations to educate patients on its disease, surgery and recovery. His expertise spans prostate cancer treatment, kidney and bladder cancer surgery, adrenal gland surgery, kidney stone treatment, penile cancer surgery and enlarged prostate management. Dr. Ramani advocates the advantages of robotic surgery-magnified 3D vision, tremor-filtered precision, minimal scarring, lower blood loss and faster recovery-helping patients return to life sooner.
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PARTIAL PENECTOMY
- Partial penectomy is done in cases where glans and distal penis is involved with carcinoma.
- Partial penectomy is a type of organ-preserving surgery. Preservation of sexual and micturational function depends on the surgical dissection and reconstruction of residual urethra.
Kidney Stone Removal
- Patients who develop stones in the kidney or ureter, often experience severe pain.
- This condition usually needs a procedure to remove the kidney stones.
- This procedure is called ureteroscopy and is performed very commonly.
- It does not require any cuts and hence it is painless.
- The procedure is performed with an endoscope inserted through the penis under spinal anesthesia.
- The scope is inserted through the penis into the kidney and stones are dissolved with a laser.
- The procedure takes about 40-50 minutes.
- A catheter (urine pipe) is kept after the procedure to drain the bladder. A stent is kept in the kidney at the same time.
- Patient is mobile and walking in the room the same evening.
- Hospital stay is one night and patient is discharged the next day after removal of the catheter.
- Patient has to come back after six weeks to remove the stent in the kidney.
- Patients can resume office a week after surgery and heavy activities like running, weight lifting, a month after the procedure.
- We offer fixed packages for this procedure which can be obtained by calling our helpline +91 9967666060.
- Men with an enlarged prostate, which is a normal ageing changes, often experiencing difficulty passing urine. This condition usually needs a procedure to trim the prostate and relieve the blockage.
- This procedure is called TURP and is performed very commonly.
- It does not require any cuts and hence it is painless.
- The procedure is performed with an endoscope inserted through the penis under spinal anaesthesia.
- The overgrown prostate is dissolved with a laser bloodlessly.
- The procedure takes about 40 minutes.
- A catheter (urine pipe) is kept after the procedure to drain the bladder.
- Patient is mobile and walking in the room the same evening.
- Hospital stay is two nights and patient is discharged with the catheter, which is removed after 4 days.
- Patients can resume office a week after surgery and heavy activities like running, weight lifting, a month after the procedure.
- We offer fixed packages for this procedure which can be obtained by calling our helpline +91 9967666060.
ROBOTIC ADRENALECTOMY FOR ADRENAL GLAND TUMOUR
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Robotic adrenalectomy is a sophisticated, complex surgery and it is very important that an experienced surgeon performs this surgery to avoid major complications.
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Once the anesthesia is done, and patient positioned, three micro cuts (3mm each) are made in the patient’s abdomen.
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The arms of the Da Vinci robot are connected to the cuts via ports (tubes).
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Dr. Ramani then sits in the controlling console to perform the surgery.
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On an average, a robotic adrenalectomy takes one hour.
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The surgery is almost completely bloodless and there has never been any need to transfuse blood after surgery.
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A urine catheter and bag to drain the bladder is inserted during surgery.
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A tiny drain pipe may be inserted in the surgical side of the abdomen, connected to a bag.
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Patient is kept nil-by-mouth the day of the surgery, with IV fluids. Sips of water are started the next day and solid food by day three.
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The drain pipe, if kept, is removed in the room on day 2 after surgery.
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The catheter is removed on day two after surgery.
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Total hospital stay for robotic adrenalectomy is 4 nights (including night before surgery).
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Post discharge, a doctor from the surgical team visits the patient at home/ hotel room once every day.
RETURN TO ACTIVITY
On the day of discharge, patient is totally self-sufficient. They are able to walk freely without any pain, dress themselves, shower, toilet and they do not need to hire any nurse or help at home. Almost all patients are back to work within 2 weeks of surgery.
Heavy activities like running, weight lifting can be resumed after a month
FOLLOW UP AFTER SURGERY
Follow up after an adrenalectomy is in the form of CT scans, once a year for 5 years.
Local patients usually meet Dr. Ramani after two weeks to discuss report.Outstation patients are counselled on a phone consultation.
ROBOTIC SURGERY FOR BLADDER CANCER
- Dr. Ramani is one of the very few surgeons in India who has the expertise to perform a robotic surgery for bladder cancer, which includes removing the urinary bladder and reconstructing a new bladder robotically.
- Robotic radical cystectomy is an extremely sophisticated, complex surgery and it is very important that an experienced surgeon performs this surgery to avoid major complications.
- Once the anaesthesia is done, and patient positioned, six micro cuts (3mm each) are made in the patient’s abdomen.
- The arms of the Da Vinci robot are connected to the cuts via ports (tubes).
- Dr. Ramani then sits in the controlling console to perform the surgery.
- On an average, a robotic radical cystectomy with an ileal conduit takes 3-4 hours.
- The surgery is almost completely bloodless and there has never been any need to transfuse blood after surgery.
- A urine catheter and bag to drain the new bladder is inserted during surgery.
- Two tiny drain pipe in inserted in the surgical side of the abdomen, connected to a bag.
- Patient is kept nil-by-mouth for 4 days after surgery with IV supplementation of patient’s daily requirements of calories, fats, carbohydrates, proteins and electrolytes.
- The drain pipes are removed in the room on day 3-5 after surgery.
- Total hospital stay for radical cystectomy is 8 nights (including night before surgery).
- Post discharge, a doctor from the surgical team visits the patient at home/ hotel room once every day.
RETURN TO ACTIVITY
- On the day of discharge, patient is totally self-sufficient. They are able to walk freely without any pain, dress themselves, shower, toilet and they do not need to hire any nurse or help at home.
- Almost all patients are back to work within 6 weeks of surgery. Heavy activities like running, weight lifting can be resumed after two months.
FOLLOW UP AFTER SURGERY
Follow up after a radical a cystectomy is in the form of CT scans, once a year for 5 years.
Histopathology report: Local patients usually meet Dr. Ramani after two weeks to discuss report.
Outstation patients are counselled on a phone consult. Depending on the report, patient may or may not need chemotherapy after surgery.
If chemo is needed, patients may choose to get it done with a medical oncologist of their choice or avail the services of one of the four medical oncologists on our team.
ROBOTIC RADICAL/PARTIAL NEPHRECTOMY FOR KIDNEY CANCER
- Robotic partial nephrectomy is a sophisticated, complex surgery and it is very important that an experienced surgeon performs this surgery to avoid major complications. Robotic radical (total) nephrectomy is
- relatively easier but still requires significant experience to consistently deliver results.
- Once the anaesthesia is done, and patient positioned, five micro cuts (3mm each) are made in the patient’s abdomen.
- The arms of the Da Vinci robot are connected to the cuts via ports (tubes).
- Dr. Ramani then sits in the controlling console to perform the surgery.
- On an average, a robotic radical nephrectomy takes one hour and a robotic partial nephrectomy takes about an hour and half.
- The surgery is almost completely bloodless and there has never been any need to transfuse blood after surgery.
- A urine catheter and bag to drain the bladder is inserted during surgery.
- A tiny drain pipe in inserted in the surgical side of the abdomen, connected to a bag.
- Patient is kept nil-by-mouth the day of the surgery, with IV fluids. Sips of water are started the next day and solid food by day three.
- The drain pipe is removed in the room on day 3 after surgery. The catheter is removed on day two after surgery.
- Total hospital stay for radical/partial nephrectomy is 4 nights (including night before surgery).
- Post discharge, a doctor from the surgical team visits the patient at home/ hotel room once every day.
RETURN TO ACTIVITY
- On the day of discharge, patient is totally self- sufficient.
- They are able to walk freely without any pain, dress themselves, shower, toilet and they do not need to hire any nurse or help at home.
- Almost all patients are back to work within 2-3 weeks of surgery.
- Heavy activities like running, weight lifting can be resumed after a month.
FOLLOW UP AFTER SURGERY
- Follow up after a radical/partial Nephrectomy is in the form of CT scans, once a year for 5 years.
- Local patients usually meet Dr. Ramani after two weeks to discuss report.
- Outstation patients are counselled on a phone consultation.