Kidney stones
Introduction
Kidney stones are small crystals or stones that form directly in the kidneys. They can remain silent for a long time, or become very painful when they move or migrate towards the ureter. Dr Dominique specializes in the complete management of kidney stones: precise diagnosis, minimally invasive treatment and prevention of recurrence.
⚠️ In the event of severe back pain, fever or blood in the urine, urgent consultation is recommended to avoid complications (infection, obstruction, kidney damage).
Symptoms and warning signs
1️⃣ Severe back pain or renal colic
- Pain is often sudden and violent, radiating to the groin or genitals.
- This is one of the most common symptoms of kidney stones.
2️⃣ Blood in urine (hematuria)
- The migration of a stone can irritate or injure the urinary wall.
- Urine becomes pinkish, reddish or brownish - or sometimes blood is only visible on analysis (microscopic hematuria).
3️⃣ Calculations visible on imaging
- Calculi can be found in the kidney, ureter or, more rarely, the bladder.
- Localization helps to adapt the treatment strategy.
4️⃣ History of kidney stones
- Recurrences are frequent.
- A metabolic work-up is often necessary to understand the origin of the stones and limit relapses.
Diagnosis
Diagnosis is based on three elements: clinical, biological and imaging.
1️⃣ Clinical examination
- Description of pain
- History of stones
- Check for signs of severity (fever, obstruction, infection)
2️⃣ Biological tests
- Urea / creatinine for renal function
- Ionogram / metabolic panel
- ECBU to detect infection
- Search for hematuria
3️⃣ Imaging
- Non-injected CT scan (non-contrast Uro-CT): reference examination for kidney stones
- Renal and bladder ultrasound: particularly useful for pregnant women or to limit radiation exposure.
- Standard radiography (ASP): still useful for certain types of radiopaque calculi.
- Intravenous urography / retrograde ur ography in certain complex cases.
Care and treatment
Treatment depends on the size, density and location of the stone, and the patient’s condition.
1️⃣ Medical and "conservative" treatment
- Abundant hydration: promotes natural elimination.
- Analgesics / anti-inflammatories: to relieve the crisis.
- Alpha-blockers or drugs facilitating passage: facilitate the progression of calculi in the ureter.
- Monitoring: : possible for stones < 5 mm without complication
2️⃣ Minimally invasive interventional treatment
Extracorporeal lithotripsy (ECL/shockwave)
- Fragmentation of the kidney stone without incision.
- Good option for certain small kidney stones.
Ureteroscopy / endoscopic ureterolithotomy
- Passage through the bladder and ureter to extract or fragment the stone, often using a laser.
Percutaneous nephrolithotomy (PCNL)
- Mini-percutaneous or conventional approach for large or complex kidney stones.
Ureteral stenting
- Helps maintain urine flow when there is an obstruction or after an operation.
📌 Dr. Dominique chooses the technique best suited to the patient, with the least invasiveness possible.
Prevention of recurrence (kidney stones)
Prevention is essential, as kidney stones have a high recurrence potential.
- Complete metabolic workup
To analyze risk factors: calciuria, oxaluria, uricosuria, urinary pH, etc.
- Dietary advice
– Drink ≥ 1.5-2 L of water/day
– Reduce salt
– Moderate animal proteins
– Limit oxalate-rich foods (depending on type of stone)
– Have regular calcium intakes (neither excessive nor too low)
- Specific treatment depending on the type of calculation
(citrates, thiazides, allopurinol, etc.)
- Regular follow-up
Imaging + urological consultation to verify absence of evolution or new formations.
Why consult a specialist urologist?
A consultation allows :
- Reliable diagnosis
- Choosing the most appropriate and least invasive treatment
- Limit complications (pain, infection, obstruction)
- Perform a precise metabolic assessment
- Implement a personalized prevention strategy
- Long-term follow-up
Do you suffer from kidney stones?
Requirements
How to prevent recurrence of urinary calculi?
In this video, I explain how to effectively reduce the risk of recurrence of urinary calculi. I share with you the essential habits to adopt on a daily basis, the mistakes to avoid and the importance of a metabolic assessment to understand the origin of your stones. My aim: to help you prevent a new attack and protect your kidney health for the long term.
Do you suffer from kidney stones?
Dr Sébastien Dominique treats kidney stone attacks as an emergency and provides comprehensive follow-up to prevent recurrences.
📍 Cabinet Urologie Paris Opéra – Paris 17e
📅 On-site or teleconsultation
📞 Book an appointment today
