Kidney Stones
Almost every stone can now be cleared without an open incision — and with the right assessment, prevented from coming back.
Understanding Kidney Stones
Kidney stones form when minerals in the urine crystallise and grow into solid masses. They are especially common across Telangana, where a hot climate and inadequate fluid intake combine to concentrate the urine — the single biggest driver of stone formation in this region.
The pain of renal colic is often described as among the most severe a person can experience. It typically begins suddenly in the flank and radiates to the groin, coming in waves and frequently accompanied by nausea, vomiting and blood in the urine.
Modern urology has largely eliminated open stone surgery. Nearly all stones are now managed with keyhole or scope-based techniques, meaning shorter hospital stays and a rapid return to work. The part that is too often neglected, however, is prevention: without metabolic evaluation, more than half of patients form another stone within ten years.
Symptoms
- Severe waves of pain in the flank radiating to the groin
- Blood in the urine, visible or detected on testing
- Nausea and vomiting accompanying the pain
- Burning or pain during urination
- Frequent urge to urinate, or passing small amounts frequently
- Cloudy or foul-smelling urine
- Fever and chills, which indicate infection and require urgent attention
- Some stones cause no symptoms at all and are found incidentally on a scan
If you recognise several of these, an assessment is worthwhile. Early evaluation usually means simpler treatment.
Causes & Risk Factors
Inadequate fluid intake
The dominant cause in our climate. Concentrated urine allows crystals to form and grow, and heat-related fluid loss makes this considerably worse.
Dietary factors
High dietary salt increases urinary calcium excretion, while excess animal protein raises uric acid. Oxalate-rich foods contribute in susceptible individuals.
Metabolic abnormalities
Excess urinary calcium, oxalate or uric acid, or low urinary citrate — the natural inhibitor of stone formation — underlie many recurrent cases.
Urinary tract infection
Certain bacteria produce struvite stones, which can grow rapidly into large staghorn calculi.
Obstruction and anatomical factors
Urinary stasis from an obstructed system, horseshoe kidney or other structural variation promotes stone formation.
Medical conditions
Hyperparathyroidism, gout, inflammatory bowel disease and obesity all raise stone risk.
Family history
A strong genetic component means stones frequently run in families.
Diagnosis at RAMS
We diagnose before we treat. Each step below is chosen for what it will actually change about your management.
Clinical assessment
Characterising the pain, its radiation and associated features, and checking for fever which would indicate infected obstruction — a urological emergency.
Non-contrast CT KUB
The definitive investigation, identifying stone size, position and density with high accuracy. Stone density also predicts how well it will respond to lithotripsy.
Ultrasound KUB
Used as a first-line and follow-up test, particularly in young patients, showing hydronephrosis and larger stones without radiation.
Urine analysis and culture
Detecting infection, blood and crystals, and guiding antibiotic choice before any intervention.
Blood tests
Kidney function, calcium, uric acid and parathyroid hormone where indicated.
Stone analysis and 24-hour urine study
Analysing the composition of a passed or removed stone, together with 24-hour urine chemistry, to build a targeted prevention plan.
Treatment Options
Treatment is matched to the cause and to your circumstances. Every option, including doing nothing for now, is explained before you decide.
Medical expulsive therapy
Small stones, generally under 6 mm, often pass spontaneously with high fluid intake, pain relief and medication that relaxes the ureter. Progress is monitored so an obstructing stone is not left too long.
Extracorporeal shockwave lithotripsy (ESWL)
External shockwaves fragment the stone without any incision, suitable for selected kidney and upper ureteric stones.
Ureteroscopy with laser (URSL)
A fine scope is passed up the urinary tract and the stone fragmented with a laser. No incision is made and most patients go home the same or next day.
Retrograde intrarenal surgery (RIRS)
A flexible scope reaches stones within the kidney itself and dusts them with laser energy — highly effective for moderate-sized kidney stones without any external puncture.
Percutaneous nephrolithotomy (PCNL)
For large or staghorn stones, access is gained through a small flank puncture. It offers the highest clearance rate for bulky stone burden.
Emergency drainage
Where an obstructed kidney is infected, urgent drainage with a stent or nephrostomy takes priority over stone removal. This situation can become life-threatening quickly.
Metabolic prevention programme
Individualised fluid targets, dietary modification and medication such as citrate or thiazides, guided by stone composition and urine chemistry.
Benefits of Treatment
- Rapid relief from severe colic pain
- Keyhole and scope-based clearance with no open incision
- Short hospital stay and quick return to work
- Protection of kidney function from prolonged obstruction
- A prevention plan that substantially reduces recurrence
- 24-hour availability for emergency presentations
Why Choose RAMS
A dedicated men's health centre in Hanamkonda — built so that sensitive concerns meet genuine specialist expertise.
20+ Years of Experience
Two decades of andrology and urology practice, including complex and revision cases.
Fellowship-Trained Andrologist
Formal sub-specialty training in andrology and men's health — uncommon in the region.
Everything Under One Roof
Consultation, diagnostics, day-care procedures and surgery at a single address.
Modern Surgical Equipment
Dedicated theatre with an operating microscope, endoscopy and uroflowmetry.
Complete Confidentiality
Private consulting rooms and access-controlled records, always.
Open 24 Hours
Urological emergencies attended round the clock, all seven days.
Dr. Rammohan Thatipamula
MBBS, MS, MCh Urology · Fellowship in Andrology & Men's Health
With more than 20 years in clinical practice, Dr. Rammohan is among the few specialists in the Warangal region with formal fellowship training in andrology alongside an MCh in urology. That combination means male sexual health, fertility and urological surgery are handled by one specialist, rather than split across departments.
Kidney Stones FAQs
Can kidney stones be treated without surgery?
Many small stones pass with fluids and medication. Larger stones need intervention, but nearly all are now treated with lithotripsy or scope-based techniques rather than open surgery.
Why do my stones keep recurring?
Because removing a stone treats the episode, not the tendency. Without metabolic evaluation, recurrence rates exceed fifty per cent within a decade. Stone analysis and a 24-hour urine study allow targeted prevention.
How much water should I drink?
Enough to produce at least 2 to 2.5 litres of urine daily, which in our climate usually means considerably more intake than that — particularly for outdoor workers. Pale, near-colourless urine is the practical marker.
Should I avoid calcium in my diet?
No, and this is a common and counterproductive misconception. Restricting dietary calcium actually increases oxalate absorption and raises stone risk. Normal dietary calcium should be maintained; it is salt and oxalate that usually need attention.
Is a stent uncomfortable?
A ureteric stent commonly causes urinary frequency, urgency and some flank discomfort. These symptoms are expected, are manageable with medication, and settle promptly once the stent is removed.
When is a stone an emergency?
Fever with flank pain suggests an infected, obstructed kidney and requires immediate attention. Uncontrollable pain, persistent vomiting or inability to pass urine also warrant coming in straight away — we are open 24 hours.
Talk to a specialist about kidney stones
Consultations are private, unhurried and completely confidential. We are open 24 hours, all seven days, in Hanamkonda.
Hospital Street, Hanamkonda, Telangana 506001 · Open 24 hours, all days