The incidence of kidney stones has increased significantly in recent years, becoming one of the leading causes of back pain, difficulty urinating, and chronic urinary tract complications.
A sedentary lifestyle, a diet rich in salt and animal protein, and prolonged dehydration trigger the crystallization of mineral salts in the urinary system.
If not treated promptly, kidney stones can lead to infection, hydronephrosis, kidney failure, or even sepsis - complications that require urgent medical intervention.
Kidney stone removal may be necessary if the stone is too large to pass.
What are kidney stones?
The nature of kidney stones
In the silence of the kidneys – two organs that seem to work silently day and night – can form “small stones” that bring pain that can make even the healthiest person collapse. Kidney stones, which sound simple, result from a complex chain of reactions inside the body, where minerals crystallize, accumulate, and grow over time, like a smoldering rebellion in the biological flow that requires absolute balance.
Formation mechanism
When urine is too concentrated, minerals such as calcium, oxalate, or uric acid increase. Under these conditions, they begin to bond together into crystals. At first, they are tiny particles. Then – if not washed out – they grow larger, developing into stones as hard as real stones.
Common forms
Calcium stones are the most common, especially in the form of calcium oxalate. Uric acid – stones that form in urine that are too acidic. Struvite – usually associated with chronic urinary tract infections. Cystine – rare, but found in people with a rare genetic disorder.
Each stone is a sign. A warning. And sometimes, a real challenge to the body.
When to remove kidney stones?
Warning from the body
Some stones lie quietly, like a stalker that has not yet acted. However, some stones burst out, causing pain, obstruction, and disorder of the entire urinary system. Removing kidney stones is not a subjective choice but a medical decision based on the level of impact and real threat to kidney function - the organ that plays a vital role in purifying the body.
Size and location
When stones are larger than 5mm, especially over 10mm, the ability to excrete through the urinary tract is greatly reduced. Stones stuck in the ureter or near the bladder can easily cause obstruction, creating back pressure on the kidney - a premise for acute kidney failure if not intervened promptly.
Severe symptoms
Prolonged renal colic, vomiting, blood in the urine, or frequent urination are all cries for help from the body. Stones cause recurrent urinary tract infections, high fever, and chills – these are no longer symptoms but indications for urgent intervention.
Risk of kidney damage
Stones can destroy kidney tissue if left for a long time. The damage is silent but persistent and sometimes cannot be completely restored. Medical intervention is now mandatory – to save the body's vital functions.
Kidney Stone Removal Methods
A Solution That Cannot Be Delayed
When kidney stones exceed the body's natural tolerance threshold, they require removal. This is no longer a simple pain-relieving action but an intervention to protect the structure and function of the kidney. The choice of method is not based on feelings but on the morphology, size, and location of the stone and the patient's overall condition.
Non-invasive treatment
Extracorporeal shock wave lithotripsy (ESWL) - uses strong sound waves to break the stone into small pieces, allowing them to be excreted through the urinary tract. Effective for small stones located in the kidney or upper ureter. Less painful and a quick recovery, but requires careful patient selection.
Endoscopic and surgical intervention
Ureteroscopy - laser lithotripsy - inserts a thin endoscope through the urethra to the site of the stone, breaks it into pieces with a laser, and then sucks it out. No skin incision, minimally invasive.
Percutaneous nephrolithotomy (PCNL) – for large, complex stones. The doctor creates a small tunnel from the skin into the kidney, breaks up, and removes the stone.
Open surgery – is rare but still the last option when other methods fail or are contraindicated.
Each technique is a trade-off between intervention – and conservation. Between effectiveness – and safety.
Things to note before and after the procedure
Preparing the space for the intervention
Every kidney stone treatment procedure, whether wave lithotripsy, laser endoscopy, or percutaneous intervention, involves a balance between risk and effectiveness. Patients do not enter the treatment with a passive mindset. They need to prepare — both physically and mentally — to ensure maximum safety and optimal recovery.
Before the procedure
The doctor will request a series of tests: CT scan, X-ray, ultrasound, complete urinalysis, and blood tests. The goal is to determine the exact location and size of the stone, assess kidney function, and detect potential infections. Patients need to stop taking anticoagulants if prescribed and fast for at least 6 hours if general anesthesia is used. Equally important is psychological stability because excessive anxiety can affect blood pressure and heart rate during the procedure.
After the procedure
Mild pain in the lumbar region or light blood in the urine is common. However, fever, increasing pain, painful urination, and difficulty urinating — are signs that you need to return for a check-up immediately. Drink plenty of water to help push the stone fragments out. Avoid strenuous exercise, especially in the first days after the procedure.
Recovery does not happen in a straight line. Each stage requires listening and cooperation from the patient.
Recovery after kidney stone removal
The post-procedure journey
Kidney stone removal is a turning point but not the end. Recovery is a challenging period where the body needs to re-establish balance after an intervention – big or small. Each lithotripsy, each percutaneous tunnel, or each endoscopy leaves biological traces that need to be properly healed.
Recovery time by method
Extracorporeal shock wave lithotripsy (ESWL) usually allows patients to return to light activities after 24–48 hours. Ureteroscopy requires about 3–5 days of rest. With percutaneous nephrolithotomy (PCNL), recovery time can last 1–2 weeks. Transient fatigue, back discomfort, or passing thin blood in the urine are common.
Care and follow-up
Drink at least 2.5 liters of water daily to help flush out remaining stone fragments. Limit salt, red meat, and foods high in oxalate. Your doctor may prescribe medications to relax the ureters or antibiotics to prevent infection. Monitoring your urine – color, volume, and sensation – is a simple and effective way to detect complications early.
Recovery is part of treatment. And in many cases, it is the deciding factor in long-term outcomes.
Risks and complications
The other side of the intervention
Although modern medicine has narrowed the gap between treatment and safety, every procedure to remove kidney stones still carries a “dark side” – where risks, although rare, can still occur. No technique is completely immune to complications. It is important to understand, monitor closely, and respond promptly.
Immediate risks
Bleeding is the most common complication, especially after percutaneous nephrolithotomy (PCNL). Although usually self-limiting, sometimes blood transfusions or vascular interventions are required. Ureteral injury – which occurs during endoscopy or laser lithotripsy – can cause urinary leakage or subsequent ureteral scarring. Sepsis, although rare, is a serious complication, especially when there is an infected stone or the patient has a prolonged obstruction.
Late and persistent complications
Ureteral stenosis, localized renal dysfunction, and recurrent stones – are consequences that may not be immediately apparent. Some patients develop new stones within 6–12 months of treatment if they do not change their lifestyle or control their risk factors.
Proactive follow-up is the best shield against the “dark” side of treatment. And it is the only way to keep medical success from complications overshadowing it.
Preventing Kidney Stones in the Future
From Treatment to Long-Term Strategy
Kidney stones, once formed, carry a hidden risk of recurrence, like a crack in the metabolic system that has not been patched up. Treatment is the first step, but prevention is the last line of defense. People with stones have a 50% risk of recurrence within 5–10 years. This is not an empty warning — it is medical data that needs to be acted upon by a scientific lifestyle.
Adjust your diet and drinking
Drinking enough water — at least 2.5 to 3 liters per day — is the foundation, not negotiable. Water dilutes urine, preventing minerals from crystallizing. Reduce sodium in your diet because salt increases calcium excretion — a major factor in stone formation. Control the amount of animal protein, especially red meat and organ meat. Maintain adequate calcium intake; do not cut it to the extreme because calcium deficiency can cause more oxalate to be absorbed in the intestine.
Monitoring and supportive treatment
For people with a tendency to relapse, stone analysis, 24-hour urine mineral concentration measurement, and metabolic assessment are necessary. If appropriate, your doctor may prescribe anti-stone drugs such as citrate, allopurinol, or thiazide.
Preventing new stones is not a matter of luck – it is a matter of perseverance in every drop of water, every portion of food, and every scheduled follow-up visit.
Cost of Kidney Stone Removal
The Value of Health and the Price to Pay
Kidney stone removal is not simply a medical procedure — it is a chain of interventions, monitoring, and care, each associated with costs. There is no fixed figure for all cases, as costs vary greatly depending on the treatment method, complexity, medical facility, and individual health insurance.
Cost by Interventional Method
Extracorporeal shock wave lithotripsy (ESWL) costs an average of VND5–15 million/session in Vietnam. Depending on the facility, the endoscopic laser lithotripsy ranges from VND20–35 million. Percutaneous nephrolithotomy (PCNL) is more complicated, requiring anesthesia and hospitalization, and can cost up to VND40–60 million. Although rarely used, open surgery is the most expensive procedure because of the long hospital stay, high risks, and costs often exceeding VND70 million.
Additional factors and financial support
Imaging tests (CT scan, X-ray, blood test, urine test), pain medication, antibiotics, and medical supplies… are all parts of the total cost. For patients with health insurance, the support level can be up to 80%, depending on the place of registration and the hospital of treatment.
Transparency about costs is an essential part of the treatment decision. Because no one just chooses the optimal method — they need to choose the feasible option.
Conclusion
Kidney stones are not a single disease but the result of long-term metabolic, dietary, and lifestyle imbalances. Stone removal is the starting point of a comprehensive recovery process, not the end.
Choosing the right treatment and combining close post-procedural monitoring and lifestyle adjustments are the three indispensable pillars of long-term management.
Proactive prevention of recurrence is the way to protect the kidneys sustainably — where every decision today will shape the vital function of tomorrow.
Frequently Asked Questions About Kidney Stones and Lithotripsy
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Do kidney stones go away on their own?
Small stones under 5mm can sometimes pass spontaneously through urine. However, this depends on the location, shape of the stone, and the speed of urine flow — not all cases can wait. -
Does laser lithotripsy cause kidney damage?
If performed correctly and with appropriate indications, the laser is considered safe. However, incorrect manipulation or overuse of high energy can cause mucosal burns, inflammation, or, more rarely, impaired kidney function. -
After stone removal, is regular follow-up necessary?
Follow-up is mandatory to assess the risk of recurrence. Usually includes ultrasound, 24-hour urine test, and diet assessment. The interval between checks depends on the individual and the cause of previous stone formation. -
What diet can prevent kidney stones?
Reduce salt, limit animal protein, drink enough water, balance calcium, and avoid foods high in oxalate, such as spinach, chocolate, and walnuts. Diet needs to be adjusted individually based on the specific type of stone. -
Is lithotripsy painful?
Depending on the method, most pain is well controlled with local anesthesia or pain relief. ESWL can cause back pain or mild burning when urinating, while laser endoscopy usually has a quick recovery and little discomfort.
