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The pain starts suddenly. It may begin in your back or side and then move toward your abdomen or groin. You try changing position, drinking water and waiting for it to settle, but the pain keeps coming back.
Then you find out you have a kidney stone.
The obvious question is, “How do I get rid of it?” But there is another question patients often overlook: does this stone actually need a procedure, and if so, what kind?
That is where a urologist can help.
When Should You See a Urologist for Kidney Stones?
Not every kidney stone requires surgery.
Some small stones can pass naturally with appropriate medical guidance. Others may become stuck, cause an obstruction, produce ongoing pain or create other complications.
A urologist looks at the complete picture before deciding whether observation, medication or a procedure is appropriate.
The pain keeps coming back
Stone pain can be severe, but it does not always remain constant.
If pain repeatedly returns or interferes with your normal activities, it is worth getting the stone properly assessed instead of relying on temporary pain relief.
The location and size of the stone can influence what happens next.
The stone is blocking urine flow
A stone can move from the kidney into the ureter and obstruct the normal flow of urine.
This can cause significant pain and, in some circumstances, affect kidney function. If an obstruction is associated with infection, it may require urgent medical attention.
The stone is not passing
Sometimes a patient waits for a stone to pass naturally, only to discover that it remains in place.
The longer a problematic stone remains stuck, the more important it becomes to discuss the available treatment options with a urologist.
What Does “Minimally Invasive” Mean?
Minimally invasive stone treatment generally means treating the stone through small access points or the body's natural urinary passage rather than making a large surgical incision.
Depending on the stone, procedures may involve a small camera, specialised instruments or laser technology.
The exact technique depends on factors such as the stone's size, location and relationship with the urinary tract.
Ureteroscopy
During ureteroscopy, a small scope can be passed through the urinary passage toward the ureter or kidney.
The urologist can locate the stone and, when appropriate, break it into smaller pieces or remove it.
For selected stones, this can provide an effective way to treat the problem without a large external incision.
Laser stone treatment
A laser may be used during certain procedures to break stones into smaller fragments.
The word “laser” can sound futuristic, but the important part is still proper patient selection. A laser is a tool used within a treatment plan; it is not automatically the right answer for every stone.
A Real-World Example: Why Stone Size Isn't the Whole Story
We have seen patients arrive with a report that simply says they have a small kidney stone. Their first reaction is often, “It is small, so I can ignore it.”
But the actual clinical picture may be more complicated.
A stone's location can matter just as much as its size. A stone causing obstruction or persistent symptoms may require a different approach from a similarly sized stone that is sitting quietly and causing no problems.
That is why we encourage patients to look beyond the number of millimetres written on the scan.
A Contrarian Insight: Don't Drink Water Until the Pain Goes Away
There is a common belief that if you have a kidney stone, you should simply drink huge amounts of water and force it out.
That is not always sensible.
Hydration is important, but aggressively drinking excessive amounts of fluid during severe obstruction does not necessarily solve the problem and may worsen discomfort. The appropriate approach depends on the individual situation.
If you know you have a stone, follow the fluid and treatment advice given by your doctor rather than assuming more water is always better.
What Happens Before Minimally Invasive Stone Treatment?
Your urologist will usually review your symptoms and imaging before recommending a procedure.
The scan helps determine where the stone is located and may provide information about its size and the urinary system around it.
You may also need urine or blood tests, particularly if there is concern about infection or kidney function.
The doctor will then explain whether the stone can reasonably be observed or whether active treatment would be more appropriate.
About Dr. Bipul Agarwal
Dr. Bipul Agarwal is a urology specialist who evaluates and manages kidney and urinary tract conditions, including urinary stones. For patients experiencing recurring stone pain or facing a procedure, his approach involves assessing the stone's size, location and effect on the urinary system before discussing treatment. This helps patients understand why a particular minimally invasive option may or may not be appropriate.
When Is a Stone More Urgent?
Certain symptoms should not be brushed aside.
Severe pain accompanied by fever or chills can be particularly concerning because an obstructed urinary system with infection can require urgent treatment.
Difficulty passing urine, persistent vomiting, significant blood in the urine or rapidly worsening symptoms also warrant prompt medical attention.
The goal is not to panic every time you have stone pain. It is to recognise when the situation may be more than a routine episode.
How Can You Reduce the Chance of Future Stones?
Removing a stone solves the immediate problem, but it may not prevent another one.
If you have recurring stones, your doctor may discuss hydration, dietary habits, medication or further testing depending on the type of stone and your medical history.
This is where long-term prevention becomes important.
A patient who keeps treating each stone episode without investigating why stones are forming may end up repeating the same cycle.
Frequently Asked Questions
1. Do all kidney stones require surgery?
No. Some stones can pass naturally. Treatment depends on factors such as size, location, symptoms, obstruction, infection and the patient's overall health.
2. What is minimally invasive treatment for kidney stones?
It refers to procedures that treat stones through small access points or the natural urinary passage rather than through a large surgical incision. Ureteroscopy and laser stone treatment are examples used in selected cases.
3. When should I see a urologist for kidney stones?
See a urologist if stones cause recurring or severe pain, do not pass, cause urinary problems or are associated with obstruction. Fever or chills with stone symptoms require prompt medical attention.
If kidney stones have become a recurring part of your life, treating the next painful episode may not be enough. Dr. Bipul Agarwal can help determine whether your stone can be observed or whether minimally invasive treatment makes more sense for your particular situation. The goal is not simply to remove today's stone, but to understand what comes next.
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