Introduction
In a healthy individual, urine production typically ranges from 1 to 2 litres per day. This is possible in the presence of a properly functioning urinary tract, which plays a key role in eliminating metabolic waste through urine. The urinary tract is a coordinated system involving the kidneys, bladder, the ureters, and urethra that work together to carry out this essential process.
However, some individuals may develop urinary tract problems, such as kidney stones (mineral deposits that can cause blockages along the urinary tract). In fact, this is a common ailment in Singapore, particularly among men over the age of 40.
Fortunately, kidney stones are highly treatable nowadays with many treatment options available, ranging from shockwaves to minimally invasive surgeries. As such, there is little reason to leave the condition untreated, as it can lead to serious complications such as impaired kidney function, severe infection, or even chronic kidney disease.
The Urinary System Explained
As mentioned, the urinary tract is made up of the following key organs:
- Kidneys: A pair of organs that filter metabolic waste and excess fluid from the blood to produce urine.
- Ureters: Thin tubes that transport urine from the kidneys to the bladder.
- Bladder: An organ that stores urine before it is emptied.
- Urethra: A thin tube that allows urine to pass out of the body.
These organs work together as a system to eliminate waste from the body, which is produced once nutrients from food are absorbed during digestion. Specifically, the kidneys play a key role in this process, with primary functions that include:
- Filtering waste from the blood to produce urine, which is then passed out of the body
- Balancing the body’s fluid levels
- Releasing hormones that help regulate blood pressure
Any problem affecting the kidneys can disrupt this metabolic function and upset the body’s overall balance.
What Are Kidney Stones?
A common kidney issue is the formation of kidney stones. These are hard deposits made of minerals and salts that develop within the urinary system. Some stones may move from the kidney into the ureter, potentially causing urinary obstruction or other painful symptoms.
As part of the kidneys’ function, urine is produced containing various waste substances that can crystallise. When there is insufficient fluid to dilute the urine, these crystals form more easily. In addition, the urine may lack certain substances that normally prevent crystals from sticking together. This creates an ideal environment for various types of kidney stones to develop. In some cases, this environment can be influenced by an individual’s diet, body weight, medical condition and other factors.
Types of Kidney Stones in Singapore
In general, there are four types of kidney stones. Identifying the specific type helps urologists prescribe the appropriate treatment and preventive measures for patients.
- Calcium stones: This is the most common type of kidney stone and can occur when there is a high concentration of calcium or a substance called oxalate in the urine.
- Uric acid stones: These may occur in individuals who consume high amounts of purines (compounds that can lead to elevated uric acid levels, like red meat), which may crystallise into stones. This condition is often hereditary.
- Cystine stones: These are rare and typically caused by a genetic disorder in which the kidneys excrete excessive amounts of cystine, an amino acid that can crystallise to form stones.
- Struvite stones: These tend to form as a result of upper urinary tract infections. Struvite stones can quickly grow in size, with little to no symptoms. They are less common than other types.
Common Symptoms of Kidney Stones in Singapore
When small, a kidney stone may not cause many symptoms. However, in most cases, having a kidney stone is hard to miss once it moves around within the kidney or passes into the ureter. At this stage, it tends to manifest as painful symptoms, such as:
- Severe flank or back pain. The pain may spread to the lower abdomen and groin.
- Blood in the urine (haematuria)
- Nausea or vomiting
- Fever and chills (if an infection is present)
- Increased urinary frequency
- Painful urination (e.g., burning sensation)
- Cloudy or foul-smelling urine
Depending on the movement and location of the kidney stone, the pain may intensify or vary accordingly.
When to See a Specialist or Urologist in Singapore
Dealing with pain from kidney stones can be challenging and may interfere with daily activities. Serious signs that may indicate an underlying condition in the urinary tract include:
- Persistent or severe pain in the back, side or groin area
- Visible blood in urine
- Signs of infection, like a fever or chills
- Difficulty passing urine
If you experience any of the above, you are encouraged to seek a kidney specialist in Singapore for a proper evaluation. Depending on the results of the initial assessment, your urologist can recommend a suitable treatment option to provide quick pain relief and support recovery.
Diagnosis and Treatment Options
In order for your urologist to come to an accurate kidney stone diagnosis, you will likely require the following tests:
- Imaging tests: This may include either an ultrasound or CT scan to visualise the location and characteristics (e.g., shape, size, composition, etc) of the stones present.
- Urinalysis: This is a form of urine testing that can detect the presence of kidney stones. During the test, a sample of the patient’s urine is collected for evaluation. Common parameters that will be tested for include:
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- Abnormal levels of urine pH level
- Abnormal levels of kidney stone-forming minerals
- Signs of a urinary tract infection
- Signs of blood in urine
By correctly identifying the type of kidney stone, your urologist will be able to tailor an appropriate treatment plan for you. This usually includes recommendations for stone removal (if required) and addressing abnormal mineral levels that may lead to stone formation.
For very small stones, patients may not require significant medical intervention and may wait for the stones to pass naturally. Pain relievers can be used to manage discomfort before and after passing small kidney stones. When necessary, your urologist may also prescribe medication that can help to relax the ureter muscles. This can help to ease the passing of kidney stones naturally through the urine.
Ensuring sufficient hydration (1.8 to 3.6 litres per day) is also important to dilute urine and prevent further stone formation.
For larger stones, treatment options may include:
- Extracorporeal Shock Wave Lithotripsy (ESWL): This treatment involves sending strong, vibrating sound waves to break up kidney stones into tiny pieces that can pass through the urine. The procedure typically lasts about 45 to 60 minutes and may cause temporary, moderate pain.
- Ureteroscopy and laser lithotripsy: Ureteroscopy and laser lithotripsy break down large kidney stones into smaller pieces so they can pass naturally through the urinary tract. Both procedures are effective for treating kidney stones greater than 2 cm. For ureteroscopy, a very thin tube called a ureteroscope is inserted through the urethra to reach the ureter. Once the stone is located, it can be broken into small pieces for natural passage through the urine. Patients are placed under anaesthesia for this procedure.
- Percutaneous Nephrolithotomy (PCNL): For large or complex stones, a minimally invasive surgery called PCNL is available. This kidney stone surgery involves making a small incision in the back or side to remove the kidney stone using miniature telescopes. It is performed under anaesthesia and is typically used for patients who are not suitable candidates for ESWL. Most patients can return home within 1 or 2 days, although recovery time varies depending on the size and complexity of the stone(s).
Today, several treatment options are available for kidney stones. For patients concerned about potential discomfort during treatment, it is reassuring to know that anaesthesia is typically used for certain procedures to ensure a painless experience. Rather than enduring ongoing pain from kidney stones, which may lead to complications, take the first step towards your recovery soon.
References
- MedlinePlus. Kidney stone analysis. MedlinePlus. Updated January 30, 2023. Accessed July 22, 2025. https://medlineplus.gov/ency/article/003425.htm
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). What are common urinary system problems? NICHD. Accessed July 22, 2025. https://www.nichd.nih.gov/health/topics/urinary
- Johns Hopkins Medicine. Anatomy of the urinary system. Johns Hopkins Medicine. Accessed July 22, 2025. https://www.hopkinsmedicine.org/health/wellness-and-prevention/anatomy-of-the-urinary-system
- Mayo Clinic Staff. Kidney stones. Mayo Clinic. Accessed July 22, 2025. https://www.mayoclinic.org/diseases-conditions/kidney-stones/symptoms-causes/syc-20355755