Kidney Stone Treatment in Bangkok

Kidney Stone Treatment in Bangkok

Advanced, minimally invasive kidney stone care — from non-invasive 3rd-generation shockwave (ESWL) and laser stone removal to long-term prevention — at Bangkok Hospital Headquarters.

Medically reviewed by Dr. Soarawee Weerasopone, MD — Board-Certified Urologist & Endourology Specialist · Research Scholar & Clinical Observer, Scott Department of Urology, Baylor College of Medicine

What Are Kidney Stones?

Kidney stones (renal calculi) are hard mineral deposits that form inside the kidneys when the urine becomes concentrated, allowing minerals to crystallize and stick together. They are extremely common, affecting roughly 1 in 10 people in their lifetime, and once you have had one stone your risk of forming another rises significantly — which is why prevention is as important as treatment. Why do kidney stones form? →

A stone may sit silently in the kidney for years, but when it moves into the ureter it can cause sudden, severe pain (renal colic), blood in the urine, nausea, and — if it blocks urine flow or triggers infection — a urological emergency requiring urgent drainage.

Common Types of Kidney Stones

• Calcium oxalate — by far the most common; linked to diet, dehydration, and metabolic factors
• Uric acid — the one type often dissolvable with oral medication; linked to high-purine diets, gout, and acidic urine
• Struvite (infection) stones — form with certain urinary infections and can grow large (staghorn)
• Cystine — rare, inherited, and tends to recur from a young age

Warning Signs

• Sharp, cramping pain in the back or side that comes in waves
• Pain radiating to the lower abdomen or groin
• Blood in the urine (pink, red, or brown)
• Nausea, vomiting, or a frequent urge to urinate
• Fever and chills — a red flag for infection that needs urgent care

Fever or shaking chills alongside stone pain is the one combination that should not wait. An obstructed, infected kidney can deteriorate quickly and needs same-day hospital assessment, often for urgent drainage, rather than a routine appointment. The same applies to pain that no medication controls, persistent vomiting, or passing little or no urine.

Treatment Options

The right treatment depends on the stone’s size, location, and type — following international (AUA/EAU) guidelines, always favoring the least invasive option that will work.

1 — Watchful Waiting & Medical Expulsive Therapy

Small stones (usually under 6 mm) often pass on their own with plenty of fluids, pain control, and medication that relaxes the ureter to help the stone move along. Learn about medical expulsive therapy →

2 — Oral Dissolution (Uric Acid Stones)

Uric acid stones are unique — they can often be dissolved with oral medication that makes the urine less acidic, avoiding surgery altogether. Read about dissolving uric acid stones →

3 — ESWL (Non-Invasive Shockwave Lithotripsy)

Focused shockwaves break the stone into tiny fragments that pass naturally — with no incision and no scope inside the body. Dr. Soarawee currently operates 3rd-generation ESWL in Thailand. What to expect afterwards, and the warning signs that need same-day care →

4 — Flexible Ureteroscopy (RIRS) with Holmium Laser

A thin flexible scope is passed through the natural urinary passage to reach the stone, which is then vaporized with a Holmium laser — no incisions, high success rates, even for harder stones. Modern flexible ureteroscopy now handles stones of almost any size, and it is Dr. Soarawee’s preferred approach wherever it is feasible. Learn about Holmium laser surgery →

5 — Very Large or Staghorn Stones

Guidelines list percutaneous nephrolithotomy (PCNL) as first-line for stones larger than 2 cm, but PCNL requires a tract created through the flank into the kidney and is considerably more invasive. PCNL is not performed at Bangkok Hospital Headquarters — Dr. Soarawee’s approach is to attempt RIRS with the Holmium laser wherever it is feasible, and where a stone genuinely requires PCNL, referral to a centre that offers it can be arranged.

Browse all kidney stone patient guides →

Preventing Stones From Coming Back

Removing a stone treats today’s problem; a prevention plan protects your future. Based on your metabolic results, we tailor a strategy that may include:

• Hydration goals — enough fluid to keep urine pale and dilute, the single most powerful preventive step. Targets are adjusted where heart or kidney disease limits how much you should drink
• Dietary adjustments — tailored sodium, oxalate, animal-protein, and citrate guidance based on your stone type. Eight habits that prevent stones →
• Targeted medication — such as potassium citrate or others, when the metabolic profile calls for it
• Regular monitoring — periodic imaging and urine testing to catch new stones early

Read the complete kidney stone prevention guide →

Frequently Asked Questions

Q1: What are the warning signs of a kidney stone?

The classic sign is sudden, severe pain in the back or side that comes in waves and may radiate to the lower abdomen or groin, often with blood in the urine, nausea, or a frequent urge to urinate. Fever and chills alongside these symptoms suggest infection and require urgent medical care.

Q2: Do all kidney stones need surgery?

No. Many small stones pass naturally with fluids, pain relief, and medication, and uric acid stones can often be dissolved with oral therapy. Surgery or shockwave treatment is reserved for stones that are too large to pass, cause blockage or infection, or fail to move on their own.

Q3: What is the best treatment for a large kidney stone?

It depends on size and location. Flexible ureteroscopy (RIRS) with Holmium laser handles many kidney and ureteric stones without incisions and now reaches stones of almost any size. Guidelines still list percutaneous nephrolithotomy (PCNL) as first-line above 2 cm; PCNL is not performed at Bangkok Hospital Headquarters, and where a stone genuinely requires it, referral can be arranged. A CT scan guides the choice.

Q4: How can I stop kidney stones from coming back?

Prevention starts with staying well hydrated so your urine is pale, plus dietary adjustments and — when needed — targeted medication based on your stone type and metabolic testing. Once you have had a stone, a personalized prevention plan can substantially lower the chance of another.

Q5: Is ESWL painful, and how soon can I recover?

ESWL is non-invasive and performed with sedation or light anesthesia, so it is generally well tolerated. Most people return to normal activities within a day or two, passing stone fragments over the following days to weeks. Some may need more than one session for larger stones.

Q6: When is a kidney stone an emergency?

Fever or shaking chills together with stone pain is the most important combination, because an obstructed kidney that becomes infected can deteriorate quickly and may need urgent drainage. Also seek same-day care for pain that the prescribed medication does not control, persistent vomiting that prevents keeping fluids down, or passing little or no urine.

Book Your Consultation

Get an accurate diagnosis and a clear treatment plan for your kidney stones.

Bangkok Hospital Telemedicine is available for patients who cannot attend in person, including international patients — arrange it in advance by email to the Urology department at bhquro@bdms.co.th. Samitivej Sriracha is in-person only.

This page is provided for patient education only and is not medical advice. It does not create a doctor-patient relationship. Fever or chills with stone pain needs same-day medical assessment. Dr. Soarawee does not provide medical assessment, advice, diagnosis or prescriptions through personal messaging channels, direct messages or social media.