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Kidney Stones Treatment in Singapore

Living with kidney stones can be painful and distressing. If you are experiencing severe flank pain, difficulty urinating, or have noticed blood in your urine, you are not alone. Kidney stones affect approximately 1 in 10 people in Singapore, with the incidence increasing due to our climate and dietary habits. Dr Tan specialises in diagnosing and treating kidney stones using evidence-based approaches, helping patients find relief and prevent future stone formation.

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Dr Tan Teck Wei

MBBS|DFD (CAW)|MRCS|MMed (Surgery)|FAMS (Urology)

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kidney stones Kidney Stones Treatment in Singapore
Types Causes Symptoms When to see a Urologist Diagnosis Treatment Complications & Prevention FAQ
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Types
Causes
Symptoms
When to see a Urologist
Diagnosis
Treatment
Complications & Prevention
FAQ

What are Kidney Stones?

Kidney stones (nephrolithiasis or renal calculi) are hard deposits of minerals and salts that form inside your kidneys. These crystalline structures develop when your urine contains more crystal-forming substances such as calcium, oxalate, and uric acid, than the fluid in your urine can dilute.

Kidney stones can vary in size from a grain of sand to a golf ball, though most stones are between 4-6mm in diameter. In Singapore’s hot and humid climate, where dehydration is common, the risk of developing kidney stones is elevated, making proper hydration and timely treatment important.

Types of Kidney Stones

Calcium Stones

The most common type, accounting for about 80% of all kidney stones. These consist of calcium oxalate, though some may be calcium phosphate. Calcium oxalate stones form when calcium combines with oxalate in the urine when fluid intake is inadequate or dietary oxalate is excessive.

Uric Acid Stones

These stones form when urine is persistently acidic, often occurring in people with gout, chronic diarrhoea, or those consuming high-protein diets. They represent about 5-10% of kidney stones and are more common in men than women.

Struvite Stones

Also called infection stones, these develop in response to urinary tract infections caused by urease-producing bacteria. They can grow quickly and become large, sometimes filling the entire kidney (staghorn calculi).

Cystine Stones

The rarest type, occurring in people with cystinuria, a hereditary disorder causing the kidneys to excrete excessive amounts of cystine amino acid. These stones tend to recur and often require lifelong management.

Causes & Risk Factors of Kidney Stones

Causes

  • Urine supersaturation: Excess levels of calcium, oxalate, or uric acid promote crystal formation.
  • Low urine volume: Inadequate fluid intake results in concentrated urine.
  • Urinary pH imbalance: Acidic or alkaline urine encourages specific stone types.
  • Metabolic disorders: Conditions affecting calcium, oxalate, or uric acid metabolism.
  • Anatomical factors: Kidney abnormalities that cause urine stasis

Risk Factors

  • Dehydration: Especially prevalent in hot, humid climates.
    Diet high in sodium, protein, or oxalates: Excessive intake of these substances
  • Obesity: Alters urinary chemistry and increases stone risk
  • Personal or family history: Up to 50% chance of recurrence within 5-10 years
  • Certain medical conditions: Diabetes, gout, hyperparathyroidism, inflammatory bowel disease
  • Medications: Some diuretics, calcium-based antacids, and protease inhibitors
  • Age and gender: More common in men aged 30-50, though incidence in women is increasing
  • Sedentary lifestyle: Limited physical activity affects calcium metabolism

Signs & Symptoms of Kidney Stones

Mild Symptoms
  • Mild discomfort in the flank or lower back
  • Slight burning sensation during urination
  • Increased urinary frequency
  • Mild nausea without vomiting
  • Urine appears slightly cloudy
  • Vague abdominal discomfort
Moderate Symptoms
  • Sharp, cramping pain in the back and side
  • Pain radiating to lower abdomen and groin
  • Pink, red, or brown urine (haematuria)
  • Persistent nausea and occasional vomiting
  • Painful urination (dysuria)
  • Strong urge to urinate frequently
  • Passing small amounts of urine
Severe Symptoms
  • Excruciating pain that comes in waves
  • Inability to find a comfortable position due to pain
  • Fever and chills (indicating infection)
  • Complete inability to pass urine
  • Severe nausea and repeated vomiting
  • Visible blood clots in urine
  • Signs of sepsis (confusion, rapid heart rate)

Kidney stone symptoms appear suddenly when a stone moves from the kidney into the ureter, causing obstruction. The intensity and location of pain often changes as the stone moves through the urinary system, with many patients describing it as the worst pain they have ever experienced.

Experiencing these symptoms?
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When to See a Urologist

You should seek immediate medical attention if you experience severe pain that prevents normal activities, blood in your urine, signs of infection (fever, chills), or complete inability to urinate. Even mild symptoms warrant medical evaluation, as early intervention can prevent complications. Kidney stones smaller than 4mm often pass spontaneously with medical support, while larger stones may require intervention.

During your first consultation, your urologist will conduct a thorough medical history, physical examination, and order appropriate imaging studies. You will discuss your symptoms, dietary habits, medical history, and any previous stone episodes. The consultation provides an opportunity to develop a personalised treatment plan based on your stone’s size, location, and composition.

Diagnostic Investigations

Accurate diagnosis begins with a detailed medical history and physical examination. Dr Tan will assess your symptoms, risk factors, and conduct a focused examination to rule out other conditions.

  • Urine Testing

    A urine test examines your urine for the presence of blood, crystals, bacteria, and pH levels. This test can indicate stone presence and identify infection. A 24-hour urine collection may be ordered for recurrent stone formers to analyse stone-forming substances.

  • Blood Test

    Measures kidney function (creatinine), calcium levels, uric acid, and electrolytes. These help identify underlying metabolic conditions contributing to stone formation.

  • Imaging Studies

    Provides definitive diagnosis. Non-contrast CT scan detects stones as small as 1-2mm with 95% accuracy. Ultrasound offers a radiation-free alternative, useful for pregnant women and children. Plain X-rays can identify calcium-containing stones but miss uric acid stones.

  • Stone Analysis

    Involves examining passed or removed stones to determine composition. This information guides prevention strategies and helps identify underlying metabolic disorders. Results take 1-2 weeks.

Kidney Stones Treatment Options

Medical Management

Medications are prescribed to manage pain and discomfort associated with kidney stones. Conservative treatment is often recommended for small stones (less than 5mm) that are likely to pass spontaneously. This approach combines using painkillers as needed, hydration to flush out stones, and alpha-blockers (medical expulsive therapy) to relax the ureter muscles and facilitate stone passage. Patients are advised to strain urine to catch stones for analysis.

Extracorporeal Shock Wave Lithotripsy (ESWL)

Non-invasive treatment using shock waves to break stones into small fragments that can pass naturally through the urinary tract more easily. Suitable for stones less than 1.5 to 2cm in size in the kidneys or upper ureter. The procedure takes about 60 minutes and is performed as day surgery. Mild sedation may be used to ensure your comfort. Success rates vary from 60-90% depending on stone size, location, and composition.

Ureteroscopy and Laser Lithotripsy

This minimally invasive procedure involves inserting a thin scope (ureteroscope) through the urethra and bladder into the ureter or kidney to visualise and fragment stones using laser energy. Stone fragments are then removed using specialised instruments (such as baskets) or allowed to pass naturally. Success rates exceed 95% for ureteral stones. The procedure is often performed under general anaesthesia, ensuring a comfortable experience.

Surgical Options

For larger stones or recurrent cases that cannot be treated with less invasive methods, we may recommend surgical options such as Percutaneous Nephrolithotomy (PCNL). This procedure involves making a small incision in the back to remove larger stones directly. It is typically performed in a hospital setting under general anaesthesia and may require a short recovery period.

Every patient’s condition is unique

Dr Tan Teck Wei will assess your medical condition and recommend the most suitable treatment approach for you.

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Complications If Left Untreated

Untreated kidney stones can lead to serious complications beyond the immediate pain and discomfort. Persistent obstruction can cause hydronephrosis (kidney swelling), leading to permanent kidney damage and loss of function. This is concerning when stones block both kidneys simultaneously.

Urinary tract infections become more likely with obstructing stones, potentially progressing to pyelonephritis (kidney infection) or life-threatening urosepsis. Infected stones require urgent treatment as antibiotics alone cannot penetrate the stone material.

Chronic obstruction may result in kidney scarring and progressive chronic kidney disease. Recurrent stones without proper management often lead to repeated painful episodes, multiple procedures, and cumulative kidney damage over time. Quality of life suffers, with patients experiencing anxiety about future stone episodes and limiting activities due to fear of pain recurrence.

Kidney Stone Prevention

Preventing kidney stones requires a multifaceted approach tailored to individual risk factors and stone composition. The foundation of prevention is adequate hydration. 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.

Dietary modifications play a crucial role. Reduce sodium intake to less than 2,300mg daily, as excess sodium increases calcium excretion. Limit animal protein to moderate portions if you form uric acid stones. Normal calcium intake (1,000-1,200mg daily) reduces stone risk by binding oxalate in the intestines.

For calcium oxalate stone formers, reduce intake of oxalate-rich foods like spinach, nuts, coffee, tea, and chocolate, or try consuming them with calcium-containing foods. Citrus fruits and juices provide natural citrate, which inhibits stone formation.

Maintain a healthy weight through regular exercise and balanced nutrition. Obesity increases stone risk through multiple mechanisms affecting urine chemistry. Regular follow-up with Dr Tan ensures early detection of new stones and adjustment of prevention strategies based on 24-hour urine testing results.

Dr Tan Scrubs Photo

Dr Tan Teck Wei

MBBS (S’pore)

DFD (CAW)

MRCS (Edin)

MMed (Surgery)

FAMS (Urology)

Dr Tan Teck Wei is a Senior Consultant Urologist in Singapore who specialises in the management of complex urological cancers, including those affecting the kidneys, prostate, and bladder.

He is fellowship-trained in open, laparoscopic and robotic surgery. He also specialises in the management of other urological conditions including:

  • Prostate Enlargement
  • Recurrent Urinary Tract Infections
  • Stones

To date, Dr Tan Teck Wei has been involved in more than 500 robot-assisted surgeries, building up his volume of cases from his fellowship training days and cementing his expertise in robotic surgery.

Dr Tan Teck Wei believes in the holistic management of his patients, and seeks to journey with them from diagnosis to cure.  Dr Tan is effectively bilingual in English and Mandarin, making him a popular choice with the young and old, as well as international patients.

Dr Tan Teck Wei possesses a wealth of specialist experience in the field of Urology. He has previously held positions as a Consultant Urologist and Director of Genitourinary Oncology at Tan Tock Seng Hospital.

Dr Tan’s expertise in conducting MRI-targeted Prostate Biopsies led to his advisory role with the Ministry of Health’s Agency for Care Effectiveness. Furthermore, he has served as an Adjunct Assistant Professor and Clinical Teacher at the National University of Singapore (NUS) Yong Loo Lin School of Medicine and the Nanyang Technological University-Imperial College London’s Lee Kong Chian School of Medicine respectively.

He has actively participated in humanitarian initiatives as a member of the Singapore Navy surgical team, collaborating with the Indonesian Navy to provide healthcare services to the communities in Padang and Ambon. It is his passion to improve the standards of healthcare to patients both in Singapore and overseas.

  • Former Consultant Urologist and Director of Genitourinary Oncology, Tan Tock Seng Hospital
  • Adjunct Assistant Professor, National University of Singapore (NUS) Yong Loo Lin School of Medicine
  • Clinical Teacher, Nanyang Technological University-Imperial College London’s Lee Kong Chian School of Medicine
  • Advisor, Ministry of Health’s Agency for Care Effectiveness
  • Surgical Team, Singapore Navy
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Living with kidney stones can be challenging, but you do not have to face it alone. Dr Tan Teck Wei is experienced in diagnosing and treating kidney stones using evidence-based approaches.

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    Frequently Asked Questions

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

    The time varies depending on stone size and location. Stones smaller than 4mm have a 90% chance of passing within 30 days. Stones 4-6mm can still pass on its own with a 50% passage rate. Larger stones rarely pass without intervention. Medications like alpha-blockers can reduce passage time by relaxing ureter muscles. During this period, adequate hydration and pain management are essential.

    Can kidney stones come back after treatment?

    Kidney stones have a high recurrence rate. Without preventive measures, approximately 50% of patients develop another stone within 5-10 years. With proper metabolic evaluation, dietary modifications, and sometimes preventive medications, recurrence risk can be reduced by up to 50%. Regular follow-up and adherence to prevention strategies are crucial for long-term success.

    What foods should I avoid to prevent kidney stones?

    Dietary restrictions depend on your stone type. For calcium oxalate stones, moderate high-oxalate foods like spinach, beets, nuts, and chocolate. Limit sodium to less than 2,300mg daily and animal protein to appropriate portions. Do not restrict calcium intake as this increases stone risk. For uric acid stones, limit purine-rich foods like red meat, organ meats and certain seafood. Dr Tan will provide specific dietary guidance based on your stone analysis and 24-hour urine results.

    Is kidney stone removal surgery painful?

    Modern kidney stone procedures are well-tolerated with appropriate anaesthesia and pain management. ESWL may cause mild discomfort during treatment and soreness afterward. Ureteroscopy is performed under general or spinal anaesthesia, with mild discomfort for several days post-procedure. PCNL may cause more discomfort initially but is well-controlled with pain medications. Dr Tan will discuss pain management options specific to your recommended procedure.

    How can I tell if I am passing a kidney stone?

    Common signs include sudden onset of severe flank or back pain, pain radiating to the lower abdomen or groin, blood in urine (pink, red, or brown colour), frequent urination with small amounts, and nausea or vomiting. The pain often comes in waves and may shift location as the stone moves. Some people experience sudden relief of pain when the stone passes into the bladder. Always strain your urine to catch the stone for analysis.

    When is emergency treatment necessary for kidney stones?

    Seek immediate medical attention if you experience severe pain uncontrolled by oral medications, high fever (above 38°C) with chills, persistent vomiting preventing fluid intake, complete inability to urinate, or visible blood clots in urine. These symptoms may indicate complications like infection or complete obstruction requiring urgent intervention. Early treatment prevents serious complications.