Kidney Stones Treatment in Singapore

Kidney stones are hard deposits formed from minerals and salts inside the kidneys. They develop when the urine contains more crystal-forming substances than can be diluted by the fluid in the urine. The stones can vary in size, from tiny crystals to larger stones. As they move through the urinary tract, they can cause significant pain, urinary issues, and other complications.

Dr. Lie Kwok Ying

Medical Council Certified Urological Specialist

BA MBBChir (Cantab)|MRCS (Edin)|FRCS (Urol)(Glasg)|FAMS

Symptoms Causes Diagnosis Treatment Prevention FAQ

Symptoms of Kidney Stones

Individuals with kidney stones may experience a range of symptoms depending on the stone size, location, and whether it is causing a blockage in the urinary system.

Severe pain

Typically begins suddenly in the side and back, below the ribs, and can radiate to the lower abdomen and groin. The pain may come in waves and fluctuate in intensity.
Blood in urine

Urine may appear pink, red, or brown due to blood cells present. This occurs when stones scratch the urinary tract lining as they move.
Frequent urination

Stones in the ureter or bladder can irritate these structures, creating a sensation similar to a urinary tract infection with frequent urges to urinate.
Cloudy or foul-smelling urine

The presence of infection alongside kidney stones can cause urine to appear cloudy or emit an unusual odour.
Nausea and vomiting

The intense pain caused by kidney stones can trigger nausea and vomiting.
Fever and chills

These symptoms may develop if an infection is present, requiring immediate medical attention as it can lead to serious complications.

Kidney Stones Causes and Risk Factors

Kidney stones form when substances in urine become highly concentrated and crystallise, creating solid masses that can grow over time if not passed naturally through urination. Several factors can contribute to their formation:

Dehydration

Inadequate fluid intake reduces urine volume, allowing stone-forming minerals to concentrate and stick together. This is especially common in hot climates or during intense physical activity.

Diet high in stone-forming substances

Consuming foods rich in oxalate, sodium, and animal protein can increase the risk of kidney stones. High-oxalate foods include spinach, chocolate, and nuts.

Family history

A family history of kidney stones increases the likelihood of developing them, suggesting a genetic predisposition.

Certain medical conditions

Disorders such as renal tubular acidosis, cystinuria, hyperparathyroidism, and urinary tract infections can alter urine chemistry, increasing the risk of stone formation.

Medications and supplements

Some medications, including certain diuretics, calcium-based antacids, and specific antibiotics, can contribute to kidney stone development.

Obesity

A higher body mass index is linked to an increased risk of kidney stones, potentially due to dietary habits and metabolic changes.

Diagnostic Methods of Kidney Stones

Imaging studies: CT scans are the most reliable method used by urologists in singapore for diagnosing kidney stones, providing detailed images of their size and location. This quick, non-invasive test detects even small stones with high accuracy. Ultrasound and X-rays may also be used, especially when minimising radiation exposure is a priority.
Urinalysis: This test examines urine for blood cells, bacteria, and crystal-forming substances. A microscopic analysis can identify crystals that indicate the type of stone, helping guide treatment. Multiple samples may be collected to assess urine composition over time.
Blood tests: These measure kidney function and check levels of substances that promote stone formation, such as calcium, phosphorus, and uric acid. Abnormalities in these levels can help determine underlying causes.
Stone analysis: If a stone is passed or surgically removed, laboratory analysis can identify its exact mineral composition. This helps determine specific causes and develop preventive strategies.

Kidney Stones Treatment Options

The approach to treating kidney stones depends on the stone’s size, location, composition, and the severity of symptoms experienced by the patient.

Non-Surgical Treatment

Monitoring: Small stones (less than 5 mm) often pass naturally with proper hydration and pain management. Patients are typically advised to drink 2–3 litres of water daily and strain their urine to collect the stone for analysis. Passage usually occurs within a few days to weeks.
Pain management: Over-the-counter or prescription pain relievers help manage discomfort while waiting for stones to pass. Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used, while stronger medications may be prescribed for severe pain.
Medical expulsive therapy: Alpha-blockers like tamsulosin relax the ureter muscles, making it easier for stones to pass. These medications are especially effective for stones in the lower ureter and can shorten the time needed for passage.
Medications for specific stone types: Certain medications can prevent stone growth or promote dissolution. For example, thiazide diuretics may help prevent calcium stones, while allopurinol can be used for uric acid stones.

Surgical Treatment

Extracorporeal shock wave lithotripsy (ESWL): This non-invasive procedure uses shock waves to break kidney stones into tiny fragments that can pass naturally in urine. It is typically used for stones smaller than 2 cm in the kidney or upper ureter. The procedure lasts about an hour and may require sedation or anaesthesia.
Ureteroscopy: A thin, flexible telescope is passed through the urethra and bladder into the ureter or kidney to locate the stone. Small instruments or laser energy are then used to break the stone into pieces or remove it. This procedure is particularly effective for stones in the mid to lower ureter and requires general anaesthesia.
Percutaneous nephrolithotomy: For larger stones (greater than 2 cm), a small incision is made in the back to access the kidney directly. A nephroscope is used to break and remove the stone. This more invasive procedure is reserved for complex or large stones and requires general anaesthesia along with a hospital stay.

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Prevention and Management

Preventing kidney stones focuses on hydration, diet, and, in some cases, medication. Drinking enough to produce at least 2 litres of urine daily is necessary. For calcium stones, reducing sodium and animal protein while getting calcium from food can help. Limiting oxalate-rich foods may prevent calcium oxalate stones while avoiding purine-rich foods lowers the risk of uric acid stones. Maintaining a healthy weight, staying active, and managing underlying conditions also reduce the likelihood of recurrence. Some individuals may need medications to adjust urine chemistry. Regular imaging and lab tests help track and prevent future stone formation.

Frequently Asked Questions

How can I tell if my pain is from kidney stones?

Kidney stone pain typically comes in waves, starts suddenly in the back or side below the ribs, and may radiate to the lower abdomen and groin. Unlike other conditions, the pain often moves as the stone travels. Urinary symptoms like blood in urine or frequent urination can help distinguish it from other causes of abdominal pain.

Will long-term dietary changes be necessary after having kidney stones?

Dietary changes depend on the stone type and risk factors. Many people can prevent recurrence with moderate adjustments and increased hydration. However, those with recurrent stones or metabolic conditions may need long-term dietary modifications.

Can kidney stones cause permanent kidney damage?

If left untreated, stones that block urine flow can cause kidney damage due to infection or pressure buildup. However, timely treatment usually prevents lasting harm. Recurrent stones or chronic infections may gradually affect kidney function over time.

Dr. Lie Kwok Ying

Senior Consultant Urologist in Singapore

BA MB BChir (Cantab)|MRCS (Edin)|MMEd (Surg)|FRCS (Glasg)(Urol)|FAMS

Dr. Lie Kwok Ying is a Senior Consultant Urologist and pioneered the use of HoLEP (Holmium Enucleation of Prostate) for benign prostatic hyperplasia (BPH) in Singapore.

He graduated from Queens’ College in Cambridge University with triple First Class Honours and subsequently qualified in 2001 with degrees in Medicine and Surgery.

Clinical Interests in Urology