Kidney Stones Surgery in Melbourne

Most kidney stones pass on their own. When they don't — or when a stone is too large, causing persistent pain, blocking urine flow, or associated with infection — treatment is needed.

Several surgical and procedural options are available. The right one depends on the size, location, and composition of the stone, as well as the individual patient's anatomy and overall health. Stone surgery is generally very effective, and most procedures are done as day cases or short-stay admissions.

Why kidney stones form

Stones form when urine becomes concentrated enough for minerals and salts to crystallise. A few things make that more likely: not drinking enough fluid, a high-salt diet, some dietary patterns, being overweight, certain medications, and metabolic or genetic conditions. A personal or family history of stones also raises the risk.

For many people the cause is a combination rather than a single factor — which is why, after a stone is treated, it's worth understanding why it formed, not just removing it. Recurrent stones often have a preventable driver behind them.

Symptoms and how stones are diagnosed

The classic symptom is sudden, severe pain in the side or back that radiates toward the lower abdomen and groin, often in waves — known as renal colic. It can come with nausea, vomiting, a frequent urge to pass urine, or blood in the urine. Some stones, though, cause no symptoms at all and are found incidentally on a scan done for another reason.

Diagnosis usually combines your history and symptoms with imaging — most often a low-dose, non-contrast CT scan, and sometimes ultrasound — to confirm the size and location of the stone. Urine and blood tests help identify infection or a metabolic cause. Size and position matter a great deal here: they largely determine whether a stone will pass on its own or needs treatment.

A stone causing obstruction alongside fever, rigors, or other signs of infection is a different and more urgent situation, and may require urgent hospital care.

When surgery is needed

Intervention is generally appropriate when a stone:

  • Is too large to pass spontaneously (typically stones over 5–6mm become progressively less likely to pass spontaneously, particularly depending on their location)

  • Is causing persistent or severe pain despite appropriate analgesia

  • Is blocking urine flow from the kidney — particularly if there is associated fever or infection, which is a urological emergency requiring prompt drainage

  • Has not passed after a reasonable observation period

  • Is in a location that makes spontaneous passage unlikely

Not every kidney stone needs surgical treatment. Many stones — particularly smaller ones in the ureter — can be managed conservatively with adequate hydration, pain control, and monitoring. The decision to intervene, and which procedure to use, is based on the stone's characteristics and the patient's circumstances.

Ureteroscopy and laser lithotripsy

Ureteroscopy is the most commonly used procedure for stones in the ureter or kidney. A small flexible or rigid camera (ureteroscope) is passed through the urethra and bladder to reach the stone, without any external incisions. A laser is then used to break the stone into fragments small enough to pass or be removed.

The procedure is performed under general anaesthesia. At the end of the procedure, a temporary internal stent (a JJ stent) is often placed to allow the ureter to heal and any remaining fragments to pass — this is usually removed a few weeks later in a brief outpatient procedure.

Some patients experience urinary frequency, urgency, flank discomfort, or blood in the urine while the stent is in place. These symptoms are common and temporary, though the degree of discomfort varies between individuals. Return to normal activities is usually possible within a few days of the ureteroscopy itself.

Ureteroscopy is highly effective for most ureteric stones and for stones in the kidney pelvis or calyces that are suitable for this approach.

ESWL — Extracorporeal Shock Wave Lithotripsy

ESWL uses focused shock waves directed at the kidney stone from outside the body to break it into smaller fragments that can then pass naturally through the urinary tract. No incision is required, and the procedure is often performed with the patient awake using sedation or analgesia.

ESWL is most suitable for stones that are not too large, are located in the kidney rather than the ureter, and are in a position accessible to shock wave targeting. It is less effective for very dense stones (such as calcium oxalate monohydrate), very large stones, or stones in certain anatomical locations.

The procedure takes approximately 45 minutes to an hour. Most patients can go home the same day. There may be some discomfort as fragments pass over the following days to weeks.

PCNL — Percutaneous Nephrolithotomy

PCNL is used for larger or more complex kidney stones where ureteroscopy or ESWL would be insufficient. A small incision is made in the back, and a nephroscope is passed directly into the kidney to break up and remove the stone.

PCNL is a more involved procedure than ureteroscopy or ESWL, typically requiring a general anaesthetic and a short hospital stay of one to two days. It is highly effective for large or complex stone burdens — often achieving complete stone clearance in a single procedure.

Recovery takes slightly longer than for ureteroscopy — most patients return to normal activities within two to three weeks.

After stone surgery — preventing recurrence

Kidney stones have a meaningful recurrence rate. After treatment, understanding why the stone formed — through metabolic evaluation including blood and urine testing — can help identify modifiable risk factors and reduce the likelihood of further stones. This is particularly important for patients with recurrent stones or a family history of stone disease.

Simple measures such as increased fluid intake, dietary adjustments, and in some cases medication can significantly reduce recurrence risk. Follow-up imaging confirms that stone clearance is complete and that the urinary tract is functioning normally.

To discuss kidney stone treatment options or arrange an urgent assessment, contact the rooms. Urgent appointments are available for patients with obstructing stones or associated infection.

Clinical note: This page provides general information and is not a substitute for individual medical advice. Treatment decisions should be based on personalised assessment and discussion of options.

Last reviewed: May 2026