Kidney stones — or renal calculi — are solid mineral deposits that form in your kidneys. They’re little’s the rare pebble that you’re doomed to pass, painlessly, and yours could be as small as a grain of sand and remain asymptomatic or grow to a golf-ball–sized that binds and then causes a secondary bacterial infection. But how serious is your stone, and when does it merit medical treatment, surgery, or an emergency room visit? Here’s a comprehensive guide:
Pain Intensity and Pattern
Renal colic: Severe pain that begins in the side or back and travels to the lower abdomen and groin. It tends to com in waves that last from 20 to 60 minutes each as the ureter spasms with passage of the stone.
If the pain is severe — the kind of 9-to-10 level on the pain scale where you can’t get comfortable in any position — it’s a big red flag.
Size of Stone and Probability of Passing
Spontaneous passage of stones less than 5mm occurs in almost 90-98% of cases over a couple of weeks.
Above 5-10mm, the probability of passing spontaneously is around 50%; stone passage and symptom resolution declines sharply thereafter.
Stones larger than 7–10mm in great part do not pass spontaneously and may need to be treated with procedures such as SWL, ureteroscopy, or percutaneous nephrolithotomy (PCNL).
Blockage and Obstruction
If the stone is blocking the ureter, urine can’t pass through properly. The kidney becomes swollen (hydronephrosis), very painful, and at risk of damage.
Symptoms of urinary retention may include urinating fewer than a few times a day, with the complete inability to urinate despite the urge (acute urinary retention), pain in the lower abdomen, or foul-smelling urine.
Urinary and Systemic Symptoms
Hematuria is also present with stones that scrap or injure the walls of the urinary system.
Pain at the time of urination, a burning sensation, or the feeling of having not completely voided are possible symptoms that may result when a stone is in the lower ureter or bladder.
Cloudy or smelly urine indicates infection.
Signs of Infection and Systemic Diseases
Fever, chills, nausea, vomiting, malaise: if the stone is connected with an infection, it’s an emergent situation to which you need to attend now.
But infected obstructed kidneys can result in sepsis or permanent kidney damage.
Diagnostic Tests for Severity Assessment
- Imaging: NCCT is the investigation of choice for the diagnosis and characterisation of stones. Ultrasound or KUB X-ray can be helpful but is sometimes negative or negative with small /radiolucent stones (e.g. uric acid).
- Urinalysis: detects blood, infection (bacteria andleukocytes) or crystals.
- Blood tests: May be effective to measure the working of kidney and look for greater amounts of calcium or uric acid- signs of the danger of a stone or metabolic problem.
- Stone analysis (when available): Aids preventive strategies — especially for people who have had stones multiple times.
When to Contact a Medical Professional?
Get emergency medical help if you have:
- The excruciating pain you have no power over,
- Pain with fever and chills,
- Blood in the urine or can’t urinate,
- Inability to keep fluids down (Nausea and vomiting),
- UTI (symptoms with obstruction)
Treatment Based on Severity
| Scenario | Typical Management |
| Stone < 5 mm, mild pain | Conservative: hydration, NSAIDs, possible alpha‑blockers |
| Stone 5–10 mm, moderate pain | Medical expulsive therapy (tamsulosin), monitored passage |
| Stone > 10 mm or obstruction | ESWL or ureteroscopy |
| Large/complex stones (e.g., staghorn) | Surgical options like PCNL or flexible ureteroscopy |
| Fever, infection, renal compromise | Emergency drainage (stenting/nephrostomy) + antibiotics |
- Ureteroscopy and Retrograde Intrarenal Surgery (RIRS): When a very thin scope is passed into the urinary tract to the level of the stone and the stone extracted directly, or broken up and removed from the kidney. RIRS, in particular, is indicated for the management of complex or large and medium-sized stones that are almost impossible to be approached by ESWL.
- Extracorporeal Shock Wave Lithotripsy (ESWL): Passing of focused sound waves (below the skin) to break stones into small pieces. Best suited for stones under 20 mm but may require more than one session.
- Percutaneous Nephrolithotomy (PCNL) : Advent method of surgery used in case of large or complicated stones through a small incision in the back to remove the stone directly. PCNL has excellent clearance rates for stones that cannot be taken care of by the less invasive methods.
- Obstructing or Symptomatic Infection: Emergency drainage with stenting or nephrostomy and antibiotics, followed by definitive stone treatment.
Prevention and Follow-Up
- Issue of hydration: drink about 2-3 litres of water every day so your urine is diluted.
- Dietary changes: avoid high sodium, animal protein, and oxalate rich food; adequate dietary calcium.
- Metabolic analysis: Repeated 24-hour urine and blood studies are useful to deal with antecedent problems.
- Medical advice: The presence of stone disease on repeated occasions should seek the help of a urologist to avoid repetition.
Conclusion: When to Worry and Who to See?
Kidney stones may turn out to be a health problem in case of unbearable pain, urinary obstruction, or infection. Signs such as unbearable back pain, blood in the urine, fever, or one who cannot pass the urine are definite indicators that one ought to seek medical help. The size, location, and the possible treatment with ESWL, medication, or surgery can be established with the help of imaging, urine, and blood tests.
When one wants a specialist treatment in gurgaon; Dr. Deepanshu Gupta is ranked amongst the best urologists who deal with kidney stones. As an experienced mentor with more than 12 years of practice and thousands of endourological cases (including PCNL and RIRS), he is a competent professional able to treat stones of any size with the help of modern methods, such as fluoroscopy-free RIRS and shock wave lithotripsy. He has trained in the best institutions across the country such as PGIMS Rohtak and RML Hospital in New Delhi where he happened to be at number one position nationally on his MCh examination.
Being a patient-centered doctor, Dr. Deepanshu offers affordable and effective kidney stone treatmnet at CureStone Gurgaon & Del NCR.
Dr. Deepanshu Gupta may be the first step on your path to relief and recovery if you experience serious and disturbing symptoms or have a confirmed kidney stone. Book your consultation today!