Ask PERS

Kidney stones are hard mineral deposits that form inside the kidneys. 

They develop when certain substances in the urine—such as calcium, oxalate, or uric acid—become concentrated and crystallize. Over time, these crystals can grow into stones.

Kidney stones can remain in the kidney or move into the ureter, the tube that connects the kidney to the bladder. When this happens, they may cause pain or blockage of urine flow.

Kidney stones form when the urine contains high levels of minerals that can crystallize. Several factors increase the risk of stone formation, including:

Often, more than one factor contributes to stone formation.

Kidney stones may cause symptoms when they move or block the urinary tract. Common symptoms include:

• Severe pain in the side or lower back
• Pain that radiates to the lower abdomen or groin
• Blood in the urine
• Nausea or vomiting
• Painful urination
• Frequent urge to urinate

Small stones may sometimes pass without causing symptoms.

Yes, many small kidney stones can pass on their own through the urine. Stones that are smaller than about 5 millimeters often pass spontaneously.

Your doctor may recommend:

• Drinking plenty of fluids
• Pain medications
• Medicines that help relax the ureter

However, larger stones may require medical or surgical treatment.

Kidney stone pain is often described as one of the most severe types of pain. It usually occurs when a stone blocks urine flow in the ureter.

The pain often comes in waves and may:

• Start in the flank or back
• Move toward the abdomen or groin
• Be associated with nausea or vomiting

Prompt medical evaluation is recommended if severe pain occurs.

Doctors diagnose kidney stones through a combination of:

• Medical history and physical examination
• Urine tests
• Blood tests
• Imaging studies

Imaging tests are important to confirm the presence, size, and location of the stone.

Common tests include:

• Urinalysis – Detects blood, infection, or crystals in the urine.
• Blood tests – Measure kidney function and mineral levels.
• Imaging studies – CT scan, Ultrasound, X-ray (in some cases).

In patients with recurrent stones, a 24-hour urine test may be recommended to evaluate metabolic causes.

A CT scan is the most accurate test for detecting kidney stones. It can show the exact size and location of the stone and determine whether it is causing obstruction.

However, ultrasound may be used instead in some situations, such as in pregnant patients or when radiation exposure should be minimized.

Yes, ultrasound can detect many kidney stones, particularly those located in the kidney. It is a safe and widely available test that does not use radiation.

However, ultrasound may miss smaller stones or stones located in the ureter. In these cases, a CT scan may be needed for a more accurate diagnosis.

Treatment depends on the size, location, and symptoms of the stone.

• Stones less than 5 mm often pass on their own
• Stones 5–10 mm may pass but sometimes require treatment
• Stones larger than 10 mm usually require intervention

Surgery may also be needed if the stone causes infection, severe pain, or obstruction of urine flow.

Treatment options depend on the size and location of the stone.

• Medical therapy – Pain medications, medicines to help pass the stone
• Ureteroscopy with laser lithotripsy
• Shock wave lithotripsy (SWL)
• Percutaneous nephrolithotomy (PCNL)

Your urologist will recommend the most appropriate treatment.

Some kidney stones, particularly uric acid stones, can be dissolved using medications that alkalinize the urine.

However, most stones—especially calcium stones—cannot be dissolved and may require other treatments if they do not pass naturally.

Ureteroscopy is a minimally invasive procedure used to treat stones in the ureter or kidney.

A thin telescope called a ureteroscope is passed through the natural urinary passage without any incision. A laser is often used to break the stone into small fragments that can be removed or passed naturally.

Laser lithotripsy is commonly used during ureteroscopy to break kidney stones into small pieces.

A laser fiber is placed directly against the stone and breaks it into fine fragments that can be removed or passed in the urine.

This technique is highly effective and widely used in modern endourology.

Percutaneous nephrolithotomy is a minimally invasive surgery used to remove large kidney stones.

In this procedure:

• A small incision is made in the back
• A narrow tract is created directly into the kidney
• Instruments are used to break and remove the stone

PCNL is often recommended for stones larger than 2 centimeters.

The duration of surgery depends on the procedure being performed.

• Ureteroscopy: 30–90 minutes
• Shock wave lithotripsy: 45–60 minutes
• PCNL: 1–3 hours

Most procedures are performed under anesthesia.

Recovery time depends on the type of procedure.

• Ureteroscopy: return to normal activities in a few days
• Shock wave lithotripsy: minimal downtime
• PCNL: hospital stay of 1–2 days

Your doctor will give specific instructions for recovery.

Yes, kidney stones can recur. About 50% of patients may develop another stone within 5–10 years if preventive measures are not taken.

Proper evaluation and preventive strategies can significantly reduce recurrence.

Preventive measures include:

• Drinking at least 2–3 liters of water per day
• Reducing salt intake
• Maintaining a balanced diet
• Limiting excessive animal protein
• Following medical advice based on stone composition

Patients with recurrent stones may benefit from a metabolic evaluation, including a 24-hour urine test.

An enlarged prostate, also called Benign Prostatic Hyperplasia (BPH), is a common condition in aging men where the prostate gland becomes larger. The prostate surrounds the urethra, the tube that carries urine from the bladder.

As the prostate enlarges, it can press on the urethra and interfere with normal urination. BPH is not cancer, but it can cause bothersome urinary symptoms.

Common symptoms include:

• Weak urine stream
• Difficulty starting urination
• Frequent urination, especially at night
• Urgent need to urinate
• Feeling that the bladder is not completely empty
• Dribbling after urination

Symptoms usually develop gradually over time.

No. BPH is not prostate cancer.

However, both conditions can cause similar urinary symptoms. Because of this, doctors may perform tests such as a PSA blood test or prostate examination to rule out cancer.

Several medications can help relieve symptoms of BPH.

• Alpha blockers (e.g., Tamsulosin, Alfuzosin) – Relax the muscles around the prostate and bladder neck.
• 5-alpha reductase inhibitors (e.g., Finasteride, Dutasteride) – Reduce prostate size over time.

Your doctor may prescribe one or both medications depending on the condition.

Laser prostate surgery uses high-energy laser technology to remove or vaporize enlarged prostate tissue.

• HoLEP (Holmium Laser Enucleation of the Prostate)
• ThuLEP (Thulium Laser Enucleation of the Prostate)

Laser procedures often result in less bleeding, shorter hospital stay, and faster recovery.

HoLEP stands for Holmium Laser Enucleation of the Prostate.

In this procedure, a laser is used to remove obstructing prostate tissue from inside the prostate capsule. The tissue is then removed from the bladder using a device called a morcellator.

HoLEP is effective for both small and very large prostates.

Prostate cancer is a disease in which abnormal cells grow in the prostate gland. The prostate is a small gland located below the bladder in men and helps produce semen.

Most prostate cancers grow slowly, but some types can grow more aggressively. Early detection and treatment can greatly improve outcomes.

PSA screening is a blood test used to detect early signs of prostate cancer.

PSA stands for Prostate-Specific Antigen, a protein produced by prostate cells. Elevated PSA levels may indicate prostate cancer but can also be caused by other conditions such as prostate enlargement or infection.

PSA testing helps identify men who may need further evaluation.

Robotic prostate surgery, also called robotic-assisted radical prostatectomy, is a minimally invasive procedure to remove the prostate gland.

The surgeon controls robotic instruments from a console, allowing precise movements through small incisions.

• Less blood loss
• Shorter hospital stay
• Faster recovery

Robotic surgery is a type of minimally invasive surgery in which a surgeon uses a robotic system to perform complex procedures with high precision.

The surgeon sits at a console and controls robotic instruments that translate the surgeon's hand movements into very precise movements inside the patient's body. The robotic system also provides a high-definition, three-dimensional view of the surgical field.

Robotic surgery is widely used in modern urology to treat conditions affecting the prostate, kidneys, bladder, and ureters.

No. Robotic surgery is not performed by a robot independently.

The surgeon is in complete control of the robotic system at all times. The robotic instruments simply translate the surgeon's movements into very precise actions.

This technology allows surgeons to operate with greater accuracy, stability, and visualization compared with traditional techniques.

Robotic surgery offers several potential advantages compared with traditional open surgery.

• Smaller incisions
• Less bleeding during surgery
• Reduced postoperative pain
• Shorter hospital stay
• Faster recovery
• Improved precision for delicate procedures

For many patients, robotic surgery allows a quicker return to normal activities.

Robotic surgery is commonly used to treat several urologic conditions, including:

• Prostate cancer
• Kidney cancer
• Ureteral obstruction
• Kidney tumors requiring partial nephrectomy
• Ureteral strictures
• Certain bladder conditions

Robotic partial nephrectomy is a surgery used to remove a kidney tumor while preserving the healthy portion of the kidney.

This procedure allows the surgeon to remove the tumor while maintaining kidney function whenever possible. Robotic assistance helps the surgeon perform precise tumor removal and reconstruction of the kidney.

Recovery after robotic surgery is usually faster compared with traditional open surgery. Most patients experience:

• Hospital stay of 1–3 days
• Less postoperative pain
• Smaller surgical scars
• Faster return to normal activities

Full recovery may take several weeks depending on the type of procedure.

Cystoscopy is a procedure in which a small camera is inserted through the urethra to examine the urinary tract.

Doctors may use cystoscopy to evaluate:

• Prostate obstruction
• Bladder abnormalities
• Urethral narrowing
• Bladder tumors

It is usually performed under local anesthesia.

Uroflowmetry is a simple test that measures how fast urine flows during urination.

The test helps determine whether urine flow is obstructed by an enlarged prostate. A weak flow rate may suggest bladder outlet obstruction.

A kidney tumor is an abnormal growth within or on the kidney. Kidney tumors may be benign (non-cancerous) or malignant (cancerous, also known as renal cell carcinoma).

Many kidney tumors are found incidentally during imaging for other conditions. Treatment depends on the size and characteristics of the tumor.

Bladder tumors are abnormal growths in the lining of the bladder. They may be benign or malignant (bladder cancer).

The most common type is urothelial (transitional cell) carcinoma. Blood in the urine is a common early symptom.

Diagnosis is confirmed by cystoscopy and biopsy. Treatment options include TURBT (transurethral resection) and other therapies depending on stage.