Urinary stones (urolithiasis)

Home Urinary stones (urolithiasis)

Understand the origin of your calculations and take action

Prevent the recurrence of urinary stones with advice from Dr. Dominique: hydration, diet, metabolic assessment and personalized follow-up.

Introduction

Introduction

Urinary lithiasis, or “kidney stones,” refers to the formation of small crystals or stones in the urinary tract (kidney, ureter, bladder). These stones can be asymptomatic or become very symptomatic when they move or obstruct the flow of urine.

Dr. Dominique specializes in the diagnosis, minimally invasive treatment, and prevention of recurrence in urology.

If a renal colic attack occurs or blood appears in the urine, prompt consultation is recommended to avoid kidney or infectious complications.

Symptoms and warning signs

  • The pain often comes on suddenly, like kidney stones: radiating to the groin, abdomen, or even the genitals.
  • It is often paroxysmal, suggesting a “blockage” of the urinary flow.
  • Sometimes accompanied by nausea, vomiting or agitation.
  • Friction or injury to the wall of the urinary tract by the stone can cause blood in the urine.
  • Hematuria can be microscopic (visible only in the laboratory) or macroscopic (pinkish, red or brownish urine).
  • In the absence of major pain, isolated hematuria should also be investigated.
  • Imaging (non-contrast CT scan, ultrasound, X-ray as appropriate) can reveal the presence of stones in the kidney (renal stones), ureter (ureteral stones) or bladder (bladder stones).
  • Location is important for deciding on the treatment strategy.
  • Some patients experience recurrences: it is essential to know their history (types of stones, location, frequency).
  • Relapses warrant a metabolic assessment (urine analysis, blood test) and stricter preventive measures.

Diagnosis

  • Interview (description of pain, medical history, risk factors)
  • Physical examination to look for signs of complicated kidney stones (fever, lumbar tenderness, hypertension, etc.)
  • Urea, creatinine: to assess kidney function
  • Metabolic profile according to context
  • Urine culture and sensitivity testing (UCST) to look for an associated infection
  • Microscopic hematuria
  • Non-contrast CT scan (Uro-CT without contrast): reference examination to locate stones, measure their density, size, anatomical relationship.
  • Renal and bladder ultrasound: particularly useful for pregnant women or to limit radiation exposure.
  • Standard radiography (KUB): still useful for certain types of radiopaque calculi.
  • Intravenous urography / retrograde urography in certain complex cases.

Care and treatment

  • Abundant hydration: encourage water consumption to dilute urine.
  • Analgesics / anti-inflammatories: used to relieve pain (depending on tolerance and contraindications).
  • Alpha-blockers or medications that facilitate passage: in some cases, to promote the spontaneous expulsion of small stones (especially in the ureter).
  • Monitoring: if the stone is small (< 5 mm, without significant obstruction), follow-up with monitoring may be sufficient.
  • Extracorporeal lithotripsy (ECL / extracorporeal shock waves) Fragmentation of the stone without incision (good option for some small kidney stones without major anatomical obstruction).
  • Endoscopic ureteroscopy/ureterolithotomy: Endoscopic intervention (introduced into the ureter via the bladder) to break up or extract the stone, often assisted by laser.
  • Percutaneous nephrolithotomy (PCNL) For large or complex kidney stones: mini-percutaneous route or standard route.
  • Intervention on bladder stones If the stone is in the bladder, it can be fragmented or removed by transurethral endoscopy (cystoscopy).
  • Ureteral stent placement Sometimes necessary to maintain urinary flow after surgery or in cases of inflammatory conditions.

Experience

Expertise in recurrent kidney stones

Prevention of relapse

Prevention of relapse

An essential aspect of treatment is prevention in order to limit recurrences:

  • Lithogenic metabolic assessment : analysis of urine and blood to identify risk factors (hypercalciuria, hyperoxaluria, hyperuricosuria, inhibitor deficiency, etc.).
  • Dietary adjustment :
    • Increased water consumption (≥ 1.5 to 2 L/day depending on tolerance)
    • Moderation of salt intake
    • Control of animal protein and dietary oxalate intake according to context
    • Adjusting calcium intake (avoiding excesses, but also deficiencies)
  • Prophylactic drug treatment according to the type of stone (thiazides, citrates, allopurinol, etc.).
  • Regular monitoring : control imaging, urological and metabolic follow-up.

Why consult a specialist urologist?

  • To confirm the diagnosis and precisely locate the stone(s)
  • To choose the most suitable technique (the least invasive possible)
  • To minimize the risk of complications (obstruction, infection, impaired kidney function)
  • To obtain a metabolic assessment and implement a personalized prevention strategy
  • For long-term monitoring to detect any possible recurrences

How to prevent the recurrence of urinary stones?

In this video, I explain how to effectively reduce the risk of recurring kidney stones. I share essential daily habits to adopt, mistakes to avoid, and the importance of a metabolic assessment to understand the origin of your stones. My goal: to help you prevent another attack and protect your kidney health in the long term.

Do you suffer from urinary stones?

Dr. Sébastien Dominique provides emergency care for kidney stone attacks , as well as follow-up care for patients prone to kidney stones . Urology Practice Paris Opéra – Paris 17th. Consultations available in person or via teleconsultation. Book your appointment today.

FAQ – Frequently Asked Questions

How do urinary stones form?

Kidney stones form when urine is too concentrated in certain mineral salts (most often calcium oxalate, uric acid, phosphates). Insufficient hydration, an unbalanced diet, and metabolic or familial predispositions are the main contributing factors.

What are the signs of a urinary stone?

The most typical sign is renal colic: intense lower back pain radiating to the groin. A kidney stone can also manifest as blood in the urine, recurrent infections, or remain asymptomatic for a long time and be discovered through imaging.

What tests allow for diagnosis?

A non-contrast abdominal and pelvic CT scan is the gold standard: it locates the stone and measures its size and density. Ultrasound is useful as a first-line investigation and in pregnant women. Blood and urine tests complete the diagnosis.

Can a kidney stone be eliminated without intervention?

Yes: most kidney stones smaller than 6 mm pass spontaneously, aided by adequate hydration and treatment to facilitate expulsion. For stones larger than 6 mm, or in cases of uncontrollable pain, infection, or kidney blockage, urological treatment is necessary.

Dr Sébastien Dominique's expertise

Chirurgien Urologue à Paris

Dr Sébastien Dominique

Urinary stones (urolithiasis): there are solutions.

Consultation appointment Surgery appointment