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Asian Healthcare Specialist
Asian Healthcare Specialist

Call Us

+65‎ 6334‎ 1486
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Call Us

+65‎ 6334‎ 1486
Make an Enquiry

Kidney Stones
in Singapore

Kidney stones can cause intense pain, often striking without warning and disrupting daily life. These hard mineral deposits form in the kidneys and can affect individuals, with various factors including climate and dietary habits potentially contributing to their development. Understanding kidney stone treatment options available in Singapore can help patients make informed decisions about their care. Dr Azhari provides comprehensive kidney stone management, from prevention strategies to modern minimally invasive procedures, aiming to deliver personalised care tailored to each patient’s specific condition.

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Dr. Nor Azhari Bin Mohd Zam

MBBS (NUS)|MRCS (Edin.)|MMed Surgery (NUS)|FAMS (Urology)

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kidney stones c Kidney Stones Treatment Singapore
Types Causes Symptoms When to See a Urologist Diagnosis Treatment Complications Prevention FAQ Conclusion
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Types
Causes
Symptoms
When to See a Urologist
Diagnosis
Treatment
Complications
Prevention
FAQ
Conclusion

What are Kidney Stones?

Kidney stones (medically known as renal calculi or nephrolithiasis) are solid crystalline deposits that form inside your kidneys when minerals and salts in your urine become concentrated. These stones can vary significantly in size, from tiny grains of sand that may pass unnoticed to large stones several centimetres wide that can block urine flow. In Singapore’s hot and humid climate, where dehydration is common, kidney stones can develop more frequently. The stones develop when your urine contains more crystal-forming substances like calcium, oxalate, and uric acid than the fluid in your urine can dilute, or when your urine lacks substances that prevent crystals from sticking together.

Types of Kidney Stones

Calcium Stones

A common type of kidney stone that forms when calcium combines with oxalate or phosphate in urine. Adequate calcium intake may help in prevention rather than contributing to stone formation. Calcium in the diet can actually bind oxalate in the gut, thereby preventing their absorption into the body and the kidneys.

Uric Acid Stones

These develop when urine is consistently acidic, often seen in patients with gout or those consuming high-purine diets rich in red meat and seafood. They can sometimes be managed with medication.

Struvite Stones

Also called infection stones, these form in response to urinary tract infections caused by specific bacteria. They can grow and become large, sometimes with few symptoms until they cause obstruction.

Cystine Stones

A less common type that occurs in people with cystinuria, a hereditary disorder causing the kidneys to excrete excessive amounts of certain amino acids. They tend to recur and require ongoing management.

Causes & Risk Factors

Causes

Kidney stones form through a complex process involving urine chemistry imbalances. Primary causes include:

  • Supersaturation of urine with stone-forming minerals
  • Insufficient urine volume due to chronic dehydration
  • Lack of natural stone inhibitors in urine (citrate, magnesium)
  • Urinary stasis allowing crystal aggregation
  • Metabolic abnormalities affecting mineral excretion
  • Anatomical abnormalities causing urine pooling

Risk Factors

Several factors may increase the likelihood of developing kidney stones:

  • Family history of kidney stones
  • Previous kidney stone episodes
  • Living in hot climates (increased fluid loss)
  • Sedentary lifestyle or prolonged bed rest
  • Obesity and metabolic syndrome
  • Certain medications (calcium supplements, diuretics, antacids)
  • Medical conditions (hyperparathyroidism, inflammatory bowel disease, chronic UTIs)
  • High-sodium, high-protein diets
  • Insufficient water intake
  • Certain age groups
  • Male gender

*Individual risk factors and their impact may vary. Consult a healthcare professional for a personalised assessment.*

Signs & Symptoms

Mild Symptoms
  • Intermittent mild back or side discomfort
  • Slight burning sensation during urination
  • Pink, red, or brown urine colouration
  • Increased urinary frequency
  • Mild nausea without vomiting
  • Feeling of incomplete bladder emptying
Moderate Symptoms
  • Sharp, cramping pain in back and side
  • Pain radiating to lower abdomen and groin
  • Pain that comes in waves and fluctuates in intensity
  • Persistent nausea with occasional vomiting
  • Cloudy or foul-smelling urine
  • Difficulty finding comfortable position
  • Low-grade fever (under 38°C)
Severe Symptoms
  • Severe pain unrelieved by position changes
  • Complete inability to pass urine (obstruction)
  • High fever (above 38°C) with chills
  • Severe nausea and repeated vomiting
  • Blood clots in urine
  • Signs of severe infection (confusion, rapid heartbeat)

Small kidney stones may cause no symptoms and pass unnoticed, while larger stones typically cause symptoms when they move from the kidney into the ureter. The pain associated with kidney stones, called renal colic, can be severe.

Experiencing these symptoms?

Consult with Dr Azhari for an accurate diagnosis and appropriate treatment plan.

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When to See a Urologist

Seek immediate medical attention if you experience severe pain that prevents you from sitting still or finding a comfortable position, pain accompanied by fever and chills, blood in your urine, difficulty passing urine, or persistent nausea and vomiting. These symptoms may indicate a kidney stone causing obstruction or infection, requiring urgent treatment. Schedule a consultation if you have recurring mild symptoms, a family history of kidney stones, or have passed a stone previously and want to seek ways to prevent a recurrence.

During your first consultation, Dr Azhari will review your medical history, perform a physical examination, and order appropriate diagnostic tests. Your symptoms will be discussed in detail, including pain patterns, urinary changes, and any previous stone episodes. Early intervention can help prevent complications like kidney damage, severe infections, and chronic kidney disease.

Diagnosis & Testing Methods

Accurate diagnosis begins with a comprehensive clinical evaluation including detailed medical history and physical examination. Your urologist will assess your symptoms, risk factors, and perform tests to identify the stone’s size, location, and composition.

Imaging studies form the cornerstone of kidney stone diagnosis. CT scan (computed tomography) without contrast is often used, providing detailed images that can detect stones and determine their location. Ultrasound offers a radiation-free alternative, particularly useful for pregnant women and children. Plain X-rays (KUB – Kidneys, Ureters, Bladder) can identify calcium-containing stones but may miss uric acid stones.

Laboratory tests provide information about stone formation risk and complications. Urinalysis checks for blood, crystals, bacteria, and pH levels. Blood tests measure kidney function (creatinine), calcium levels, and uric acid. If you pass a stone, analysis determines its composition, which may help guide prevention strategies.

A 24-hour urine collection, performed after stone passage or treatment, measures various substances that promote or inhibit stone formation. This comprehensive metabolic evaluation may help identify underlying causes and guide prevention strategies. Your urologist can develop a treatment and prevention plan based on these findings.

Treatment Options Overview

Treatment largely depends on 2 main factors. Firstly, the stone factor which comprise the number, size, site and hardness of the stone. The other consideration is the patient factor – the symptoms he is experiencing, his medical fitness and overall health.

Conservative Management

For stones smaller than 5mm that aren’t causing severe symptoms or complications, conservative management allows natural passage. This approach includes increased fluid intake, pain medication, and alpha-blockers to relax ureter muscles. Small stones may pass naturally, suitable for patients without infection or severe obstruction.

Medical Expulsive Therapy

Alpha-blockers such as tamsulosin help relax smooth muscles in the ureter, facilitating stone passage for stones 5-10mm in size. Combined with adequate hydration and pain management, this treatment may help with stone passage. Treatment typically continues with regular monitoring.

Dissolution Therapy

Uric acid stones can be dissolved using medications that alkalinise urine, such as potassium citrate or sodium bicarbonate. This approach requires maintaining appropriate urine pH through regular monitoring. However, as this kind of treatment takes time to be effective, it is less suitable for stones which are causing acute symptoms or obstruction.

Extracorporeal Shock Wave Lithotripsy (ESWL)

ESWL uses focused shock waves to fragment stones into smaller pieces that pass naturally. This outpatient procedure requires no incisions. Suitable for stones in the kidney or upper ureter, ESWL may be effective depending on stone location and composition. Multiple sessions may be needed for larger or harder stones.

Ureteroscopy with Laser Lithotripsy

This minimally invasive procedure involves passing a thin scope through the urethra and bladder to reach stones in the ureter or kidney. A laser fibre fragments the stone into dust or small pieces that are removed or pass naturally. This day-surgery procedure aims to provide stone clearance and symptom relief.

Percutaneous Nephrolithotomy (PCNL)

For large stones, staghorn calculi, or stones resistant to other treatments, PCNL provides direct kidney access through a small back incision. Under general anaesthesia, the urologist fragments and removes stones using specialised instruments. This procedure may achieve stone clearance for complex stones, though it requires hospitalisation.

Laparoscopic or Open Surgery

Reserved for exceptional cases where other treatments fail or aren’t suitable, surgical stone removal may be necessary for very large stones, stones associated with anatomical abnormalities, or non-functioning kidneys. Modern laparoscopic techniques minimise invasiveness while providing treatment.

Every patient’s condition is unique.

Dr Azhari will assess your specific situation and recommend the most suitable treatment approach for you.

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Complications if Left Untreated

Untreated kidney stones may lead to health consequences beyond immediate pain and discomfort. Persistent obstruction can cause urine to back up into the kidney, potentially leading to hydronephrosis (kidney swelling) and kidney damage. Over time, this might result in loss of kidney function, particularly if both kidneys are affected or if you have only one functioning kidney.

Stones can create conditions for bacterial growth, which may increase risk of urinary tract infections and potentially serious complications such as urosepsis. Infections can cause kidney scarring and may contribute to kidney function decline. Repeated stone episodes without appropriate medical management might lead to chronic kidney disease.

Quality of life may be affected with untreated stones. Pain episodes, medical visits, and activity limitations can impact physical and mental wellbeing. Anxiety about pain recurrence may affect daily functioning and relationships. Appropriate medical treatment and prevention strategies aim to help avoid these complications whilst supporting kidney function and quality of life.

Prevention

Preventing kidney stone recurrence requires a tailored approach based on your stone type and risk factors. Adequate hydration remains an important aspect of prevention – aim for 2.5-3 litres of fluid daily, producing at least 2 litres of urine. In Singapore’s climate, increase intake during outdoor activities or exercise.

Dietary modifications can play a role in stone prevention. Consider reducing sodium intake, as excess sodium may increase calcium excretion. Limiting animal protein to appropriate portions, particularly red meat and seafood high in purines, may be beneficial. Contrary to popular belief, maintaining normal calcium intake through food sources rather than supplements may help, as dietary calcium can bind oxalate in the intestines.

For calcium oxalate stones, moderate consumption of high-oxalate foods like spinach, nuts, chocolate, and tea may be considered. Increasing citrate intake through citrus fruits and juices may help inhibit stone formation. Maintaining healthy weight through regular exercise and balanced diet may be beneficial, as obesity can increase stone risk.

Dr Azhari may prescribe preventive medications based on your metabolic evaluation. These might include thiazide diuretics to help reduce calcium excretion, allopurinol for uric acid stones, or potassium citrate for various stone types. Regular follow-up helps ensure prevention strategies remain effective and can be adjusted as needed.

Frequently Asked Questions

How long does it take to pass a kidney stone naturally?

Stone passage time varies significantly based on size and location. Smaller stones may pass more readily than larger ones. Factors like hydration, physical activity, and medications can influence passage time. Your urologist will monitor progress and may recommend intervention if the stone doesn’t pass within a reasonable timeframe or if complications develop.

Can kidney stones come back after treatment?

Kidney stones can recur without prevention measures. Recurrence risk depends on underlying causes, stone type, and adherence to prevention strategies. Metabolic abnormalities, family history, and certain medical conditions may increase recurrence likelihood. Proper evaluation, targeted prevention strategies, and lifestyle modifications can help reduce recurrence risk. Regular follow-up with your urologist ensures early detection and management of new stones.

What foods should I avoid if I have kidney stones?

Dietary recommendations depend on your stone type, determined through stone analysis and metabolic evaluation. For calcium oxalate stones, you may need to moderate high-oxalate foods like spinach, beets, nuts, chocolate, and tea. Limiting sodium and reducing animal protein portions may be recommended. For uric acid stones, avoiding high-purine foods including organ meats, anchovies, and excessive seafood may be advised. Adequate dietary calcium intake is generally recommended. Your urologist or dietitian will provide personalised dietary guidelines based on your specific stone composition and risk factors.

Is kidney stone treatment painful?

Modern kidney stone treatments are designed to minimise discomfort. ESWL may cause mild discomfort during the procedure, which can be managed with pain medication or sedation. Ureteroscopy is performed under anaesthesia, though mild discomfort may occur afterwards. PCNL, being more invasive, requires general anaesthesia and post-operative pain management. Your urologist will discuss pain management options and aim to ensure your comfort throughout treatment and recovery.

How much water should I drink to prevent kidney stones?

Adequate fluid intake is important for kidney stone prevention. In Singapore’s hot climate, you may need increased fluid intake, especially during outdoor activities. Spreading intake throughout the day, including before bedtime, can help prevent overnight urine concentration. Water is generally recommended, though citrus juices may provide additional benefits. Monitoring urine colour can help assess hydration status – pale yellow typically indicates adequate hydration. Your urologist may recommend specific targets based on your stone risk and individual assessment.

When is surgery necessary for kidney stones?

Surgery may become necessary when stones are too large to pass naturally, cause persistent obstruction despite medical therapy, or are associated with infection or kidney function concerns. Large branched stones filling the kidney typically require surgical intervention. Surgery may also be indicated for stones causing persistent pain, recurrent infections, or in patients with certain kidney conditions. Anatomical abnormalities contributing to stone formation may require surgical correction. Your urologist will recommend surgery when less invasive options are unsuitable or have not been effective. Treatment recommendations are individualised based on clinical assessment.

Conclusion

Kidney stones, while painful and disruptive, are treatable with various management options available. From conservative approaches for small stones to minimally invasive procedures for complex cases, modern urology offers treatment options tailored to each patient’s specific situation. The key lies in accurate diagnosis, appropriate treatment selection, and comprehensive prevention strategies to reduce recurrence risk. With proper medical care and lifestyle modifications, patients may successfully manage kidney stones and help prevent future episodes, maintaining kidney health and quality of life.

Take the First Step Towards Better Health

Living with kidney stones can be challenging, but you don’t have to face it alone. Dr Azhari has extensive experience in diagnosing and treating kidney stones using current evidence-based approaches. He will also recommend strategies to prevent the stone from recurring in the future.

Book Your Consultation Today
Dr. Nor Azhari Bin Mohd Zam

Dr. Nor Azhari Bin Mohd Zam

MBBS (NUS)|MRCS (Edin.)|MMed Surgery (NUS)|FAMS (Urology)

With more than 15 years experience as a certified Urologist, Dr Nor Azhari specializes in treating a wide range of kidney, bladder and prostate conditions as well as disorders of the male reproductive organs.

He offers minimally invasive treatment options and provides same-day appointments for convenience.

  • Skilled urologist and kidney stone surgeon.
  • Director of Endourology (Urinary stone service) at Singapore General Hospital – 2016 to 2023.
  • Recognized with the College of Surgeons Gold Medal and Singapore Urological Association Book prize.
  • Minimally invasive treatment options available (non-invasive and endoscopic/key-hole techniques).
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