Kidney Stone Treatment in Indore

Kidney stones (nephrolithiasis) affect millions of people in India, with Madhya Pradesh and other central Indian states bearing a disproportionately high burden due to the hot climate, hard water supply and dietary patterns prevalent in the region. Stones range from a grain of sand to several centimetres and can produce some of the most severe pain a person experiences (renal colic). CARE CHL Hospitals, Indore, offers the full spectrum of kidney stone investigation and treatment, ranging from conservative management to minimally invasive surgical removal, within a single specialist urology unit.

What Are Kidney Stones?

Kidney stones form when substances normally dissolved in urine like calcium, oxalate, uric acid or phosphate, become concentrated enough to crystallise within the kidney or urinary tract. Common types of kidney stones are:

• Calcium oxalate stones account for approximately 75 to 80% of all kidney stones, forming when urine contains too much oxalate relative to available fluid.
• Uric acid stones develop in acidic urine and are associated with gout, dehydration and high animal protein.
• Struvite stones form during urinary tract infections.
• Cystine stones result from a rare inherited amino acid disorder.

Symptoms of Kidney Stones

Symptoms depend on the size and location of the stone; small stones in the kidney itself may produce no symptoms at all until they begin to move.

• Renal colic - sudden, severe cramping pain in the flank, between the ribs and hip is the hallmark symptom, typically arriving in waves as the stone moves through the urinary tract. Other symptoms are
• Pain radiating from the flank into the lower abdomen, groin, or inner thigh follows the course of the ureter as the stone travels downward.
• Haematuria or blood in the urine (from microscopic traces detectable only on testing to frank red discoloration), is present in the majority of stone episodes.
• Nausea, vomiting, and urinary urgency commonly accompany the pain, particularly as the stone approaches the bladder.

Causes of Kidney Stones

Stone formation reflects an imbalance between the substances that promote crystallisation and those that normally inhibit it within the urine. This occurs due to:

• Chronic dehydration produces concentrated urine with a higher mineral load - the single most important modifiable factor in stone formation across all stone types.
• Dietary sodium raises urinary calcium excretion, while excess oxalate (found in spinach, nuts, chocolate, and tea) directly increases the risk of calcium oxalate stones.
• Hyperparathyroidism (overactivity of the parathyroid glands) raises blood and urine calcium levels, causing recurrent calcium stones, and should be excluded in patients with multiple stone episodes.
• Recurrent urinary tract infections caused by urease-producing bacteria generate the alkaline urine in which struvite stones form, sometimes growing to fill the entire renal pelvis (staghorn calculus).

Risk Factors for Kidney Stones

Several factors increase the likelihood of forming a kidney stone beyond the general population risk. They are:

• A personal or family history of kidney stones is the strongest individual predictor of future stone formation, reflecting inherited metabolic tendencies and shared dietary and environmental exposures.
• Obesity, type 2 diabetes and metabolic syndrome are each independently associated with uric acid stone formation through their effects on urinary pH.
• Anatomical urinary tract abnormalities, including horseshoe kidney, medullary sponge kidney and ureteropelvic junction obstruction, promote stone formation by impairing normal urine drainage.

Possible Complications of Kidney Stones

Untreated or recurrent kidney stones can cause progressive damage to the kidney and urinary tract. They can cause:

• Obstructive uropathy (occurs when a stone blocks a ureter) can cause the kidney to dilate (hydronephrosis) and its function to decline if the obstruction is not relieved promptly.
• Urosepsis is a life-threatening systemic infection arising from a blocked and infected kidney that can develop within hours of complete ureteric obstruction with concurrent infection.
• Chronic kidney disease results from repeated stone episodes, particularly in patients with metabolic disorders or structural abnormalities who form stones continuously without preventive treatment.

When Should You See a Urologist

Contact a urologist if you experience:

• Severe pain, pain associated with fever, or pain not easing within a few hours 
• A stone that has not passed within four to six weeks, is not reducing in size on follow-up imaging, or causes persistent symptoms 
• Anyone who has had two or more stone episodes or who forms stones at a young age should see a urologist for a metabolic evaluation to identify and correct the underlying cause.

Diagnosis of Kidney Stones

Diagnosis confirms the stone's size, location and composition and identifies any associated obstruction or infection.

• Non-contrast CT KUB (computed tomography of the kidneys, ureters, and bladder) is the gold-standard investigation, identifying virtually all stone types with high accuracy.
• Ultrasound is a radiation-free alternative for pregnant patients and children, particularly useful for detecting hydronephrosis, though it may miss small ureteric stones.
• Urinalysis and urine culture assess for blood, infection and urine pH. 
• Blood tests check serum creatinine, calcium, uric acid and parathyroid hormone relevant to stone recurrence.

Kidney Stone Treatment

Treatment selection depends on stone size, composition, location and any associated obstruction:

• Conservative management: High fluid intake, NSAIDs or opioid pain relief, and an alpha-blocker medication (to relax ureteric smooth muscle) are appropriate for stones below 5 to 6 mm without fever, as the majority of stones pass spontaneously.
• ESWL (extracorporeal shockwave lithotripsy): This noninvasive procedure uses shock waves to fragment the stone into small passable particles and is effective for renal and upper ureteric stones up to approximately 15 to 20 mm without dense composition.
• URS (ureteroscopy): URS with holmium laser lithotripsy is standard for ureteric stones of any size and renal stones below 15 to 20 mm.
• PCNL (percutaneous nephrolithotomy): This uses a small skin puncture into the kidney through which a nephroscope removes stones and is the treatment of choice for stones above 20 mm, staghorn calculi, and stones that failed ESWL or URS.
• Metabolic evaluation with preventive treatment like Dietary modification and preventive medicines reduces the recurrence risk.

Why Choose CARE CHL Hospitals for Kidney Stone Treatment in Indore?

CARE CHL Hospitals, Indore, provides the full range of urological stone treatment through an experienced team trained in flexible ureteroscopy with laser lithotripsy, mini-PCNL (percutaneous nephrolithotomy through a smaller-calibre puncture, reducing blood loss and recovery time), and ESWL. The department is equipped with digital fluoroscopy, intraoperative ultrasound and holmium laser lithotripsy systems, ensuring precise, minimally invasive stone clearance.

All patients undergo metabolic evaluation after their first significant stone episode to identify and treat the underlying cause, reducing recurrence risk. Stone composition analysis is performed routinely to guide dietary and pharmacological prevention, and long-term follow-up through dedicated urology clinics ensures ongoing care beyond the immediate stone episode.