Kidney stones, also known as urinary stones, are a widespread health issue affecting millions globally. Singapore is located within the global stone belt alongside India, Thailand, Vietnam and Indonesia as they have a high incidence of kidney stones. These hard mineral and salt deposits form in the kidneys and can cause intense pain when they travel through the urinary tract. Renal or ureteric colic occurs when urine flow is obstructed, and the kidneys swell. The severe pain is often described as worse than giving birth by ladies and the worst pain encountered by most men.
Dr Jay Lim
MBBS (Syd), MRCS (Edin), MRCS (Glasg), MMed (NUS), FAMS (Urology)
Dr Lim Kheng Sit (Jay) is a urologist specialising in kidney diseases, including acute renal colic, horseshoe kidneys, pregnant-related, stone-related, and single kidney patients. He has particular expertise in the management of kidney stone disease, including complex and high-risk cases, and performs advanced minimally invasive procedures such as Percutaneous Nephrolithotomy (PCNL), flexible ureteroscopy and laser lithotripsy.
Kidney stones, or renal calculi, form when minerals and salts in your urine become concentrated and crystallise into hard deposits.
A stone may remain in your kidney without causing discomfort. However, when it moves into the ureter, the tube connecting your kidney to your bladder, it can obstruct urine flow and cause significant discomfort.
Prolonged obstruction may cause kidney swelling, known as hydronephrosis, and affect kidney function.
Your stone’s composition helps determine which treatment may work and how you can reduce your risk of developing another.
Calcium stones are the most common type. Low fluid intake, high urinary calcium and oxalate-rich foods such as spinach and peanuts may contribute to their formation. Dietary prevention often targets these factors. However, you should not automatically eliminate calcium, as adequate dietary calcium can help reduce oxalate absorption.
Uric acid stones are associated with acidic urine, gout and diets high in purines, including organ meats and certain seafood. Unlike most other stones, uric acid stones can sometimes be dissolved by alkalinising your urine with prescribed medication.
Struvite stones develop in association with certain urinary tract infections, including recurrent infections. They can grow into large, branching stones that fill the kidney’s collecting system. These generally require surgical clearance alongside infection treatment rather than watchful waiting.
If you experience recurrent urinary tract infections, your urologist may investigate whether an underlying stone is contributing to them.
Cystine stones develop in people with cystinuria, an inherited condition. They often appear at a younger age and can recur throughout life. If you or your family members had repeated stones early in life, further investigation may be appropriate.
Your symptoms depend on where the stone is located and whether it obstructs urine flow. They may progress from mild discomfort to severe pain.
Common signs include:
An obstructing stone may also cause hydronephrosis, which does not always produce a separate symptom.
Seek immediate medical attention if you experience any of the following. They could be signs of an obstructed kidney, which is a medical emergency:
Early diagnosis and treatment are critical to preventing complications such as kidney damage or recurrent infections.
If you think you may be presenting symptoms of Kidney Stones, Consult a Specialist as soon as possible.
Kidney stones form when urine becomes too concentrated for certain minerals and salts to remain dissolved. Several factors contribute to kidney stone formation, many of which are preventable:
Insufficient fluid intake leads to concentrated urine, increasing stone risk. Singapore’s year-round heat and humidity can increase your daily fluid needs, particularly when you work or exercise outdoors.
High sodium, sugar, and protein consumption can promote stone development.
Obesity and inactivity are linked to higher risks of stone formation.
Gout, hyperparathyroidism and recurrent UTIs can contribute to stone formation.
Anatomical variations, including horseshoe kidneys, may affect urine drainage. If you have a single functioning kidney, an obstructing stone requires particular attention because it may affect your remaining kidney function.
Imaging establishes the stone’s size, position and whether it is causing obstruction. These findings help your urologist decide whether observation or removal is appropriate.
Non-contrast CT KUB is a standard confirmatory imaging test for many adults with suspected kidney stones. The scan takes only minutes, requires no contrast injection and shows the stone’s size, location and signs of obstruction. It also measures stone density, which helps predict whether shockwave treatment for kidney stones may work, as denser stones can be harder to fragment.
Ultrasound may replace CT when radiation exposure should be minimised, such as during pregnancy. A KUB X-ray may be used to monitor stones visible on plain radiographs during follow-up. However, small stones and stones in the lower ureter may be missed, particularly on ultrasound.
Urinalysis checks for blood and signs of infection. A urine culture may be requested if infection is suspected.
Blood tests assess kidney function, calcium and uric acid levels, helping identify complications and possible causes.
Not every stone requires surgery. Your urologist will consider its size, location, composition, symptoms and effect on kidney function before recommending treatment. Key approaches include:
Small ureteric stones, particularly those under 5 mm, may pass naturally. If your symptoms are controlled and there is no infection or worsening obstruction, treatment may involve pain relief, adequate hydration and medication to help selected stones pass.
Observation may continue for approximately four to six weeks in suitable patients, with follow-up imaging to confirm passage.
Persistent pain, infection or deteriorating kidney function may require earlier intervention.
ESWL uses focused shockwaves to break stones into smaller fragments without an incision.
During shockwave treatment for kidney stones, imaging helps your doctor locate the stone before directing shock waves towards it from outside your body. The fragments may then pass through your urine.
Larger or denser stones may require additional sessions or another procedure.
Ureteroscopy reaches stones through your natural urinary passage without an external incision.
URS treats ureteric stones, while retrograde intrarenal surgery (RIRS) uses a flexible scope to reach stones within the kidney. A laser breaks the stone into fragments, which may be retrieved using a small basket.
Your urologist may also insert a temporary ureteric stent to support urine drainage.
PCNL is generally considered for larger or complex kidney stones, commonly those exceeding 2 cm. Your urologist makes a small flank or back incision to access the kidney directly and remove the stone.
Mini-PCNL uses smaller instruments in selected cases. PCNL usually requires hospital admission and a longer recovery period than ESWL or ureteroscopy.
| Treatment | Typical Stone Size | Anaesthesia | Hospital Stay | Recovery |
|---|---|---|---|---|
| ESWL | Selected smaller stones, often under 2 cm | Analgesia, sedation or anaesthesia | Usually day procedure | Often a few days |
| URS/RIRS | Ureteric stones and selected kidney stones, often under 2 cm | Usually general anaesthesia | Day surgery or overnight | Several days |
| PCNL | Larger stones, commonly over 2 cm | General anaesthesia | Usually inpatient | Often 1 to 2 weeks for routine activities |
These are general indications, not fixed treatment thresholds. Stone position, density and anatomy also influence the choice of procedure.
At Urocare, Dr Jay Lim provides assessment and management for kidney stones, from conservative treatment to procedural removal.
Recovery depends on your procedure, stone burden and whether a ureteric stent has been inserted.
Mild blood staining in urine, stinging, flank ache and stent discomfort can occur after treatment. Contact us if pain or bleeding worsens or vomiting persists. Fever, chills or inability to urinate require urgent assessment.
After uncomplicated ESWL, you may return to desk work within one or two days. URS or RIRS may require several days, while PCNL often requires approximately one to two weeks before routine activities.
Physical work, heavy lifting and strenuous exercise may require longer restrictions. Avoid driving while taking sedating medication or recovering from anaesthesia.
Pain relief does not necessarily mean every fragment has passed. Your urologist may arrange an ultrasound, X-ray or CT scan to confirm clearance and check that obstruction has resolved.
If a stent was inserted, removal may be arranged within days to a few weeks, depending on your procedure and recovery.
Follow-up imaging is important because residual fragments can remain after stone treatment, even when symptoms improve.
Kidney stone removal cost in Singapore depends on your stone’s size, the procedure required and the number of treatment sessions.
Your total bill may include consultation, imaging, urine and blood tests, procedure and anaesthesia fees, facility charges, stent insertion or removal, and follow-up appointments.
We can provide a more relevant estimate after reviewing your scans.
Eligible procedures may be claimable under MediSave, MediShield Life or an Integrated Shield Plan, subject to applicable limits and policy terms.
MediSave allows a daily hospital charge limit plus a surgical withdrawal limit based on the procedure’s classification under Singapore’s Table of Surgical Procedures.
You can check the Ministry of Health’s current MediSave limits and review the clinic’s insurance partners before treatment.
Public hospitals offer subsidised treatment for eligible patients through the appropriate referral pathway, although non-emergency appointment and procedure waits vary.
Private treatment often offers greater flexibility when choosing your surgeon and scheduling care. Urocare offers same-day consultations where appointments are available. Talk to us to know more.
Kidney stones can recur, with recurrence reported in up to approximately 50% of first-time stone formers within five years without preventive treatment.
Your prevention plan should account for your stone composition, hydration habits and underlying risk factors.
If you experience recurrent stones, your urologist may recommend analysing a passed or removed stone to identify its composition.
A 24-hour urine collection measures factors such as calcium, oxalate, uric acid, citrate and urine volume.
Together, these results help turn general prevention advice into a plan based on your specific stone type and risk factors.
Consider consulting a kidney stone specialist in Singapore if a routine scan identifies a stone, you experience repeated episodes, or you have a family history of kidney stones.
Assessment is also important if you have a horseshoe kidney or a single functioning kidney.
A urologist for kidney stones can review your imaging, explain your options for kidney stones removal in Singapore and recommend appropriate follow-up.
Led by an experienced urologist, our clinic focuses on conditions affecting the prostate, kidney, bladder, and male reproductive conditions, ensuring patients receive targeted, specialist care.
Patients get access to timely consultations to address urgent or discomforting urological symptoms, reducing delays in diagnosis and treatment.
Most of our surgical procedures are claimable by integrated shield and corporate insurance plans, making treatment more accessible and providing greater peace of mind.
Sensitive conditions are discussed with a specialist in a discreet and comfortable environment, allowing patients to feel at ease and supported by a smooth care experience.
Kidney stones can be distressing, but with the right knowledge and preventive strategies, you can effectively manage and reduce your risk. Stay hydrated, follow a balanced diet, and consult a urologist for tailored advice.
Our friendly team at Urocare is looking forward to serving you.
For urgent enquiries and appointment requests, please call the clinic directly.
No, not all stones need to be surgically removed. As a simple rule, if the stone is larger than 3 mm, there is a risk of blocking the urine flow if it moves into the ureter. Stones smaller than 2 mm can be conservatively managed and flushed out with adequate hydration.
Common stone removal methods include shockwave therapy, which does not involve any cuts on the patient. These are very tolerable day procedures, and patients usually are up and about the following day with very little downtime.
Where surgery is required, most patients are well enough to be discharged the following day and managed at home.
A temporary ureteric stent is sometimes placed after ureteroscopy or laser stone removal to keep urine draining while the ureter heals. Not every procedure needs one.
A stent can cause urinary urgency, frequency, mild flank ache and some blood in the urine. These usually settle once it is removed, typically within days to a few weeks, depending on your procedure and recovery.
Modern kidney stone surgery does not involve any cuts, unlike appendicitis or gallbladder surgery. However, ureter stents are commonly placed in the kidney during surgery to ensure the urine stone is not compromised.
This can cause some discomfort to patients for the next 3 days. As a result, a period of hospital leave is given to the patient after any surgery.
Kidney stone removal cost in Singapore depends on the stone’s size, the procedure required (ESWL, ureteroscopy or PCNL) and the number of sessions needed. Your bill may also include consultation, imaging, anaesthesia, facility charges, stent insertion or removal and follow-up visits.
Eligible procedures may be claimable under MediSave, MediShield Life or an Integrated Shield Plan. We can provide a clearer estimate after reviewing your scans.
Kidney stones treatments are covered by insurance and MediShield, although the degree of coverage differs from insurance plans. Renal colic are considered medical emergencies, which require hospitalisation and is a common insurance claim.
While most insurance covers hospitalisation, It is best to check with our team on your insurance coverage.
Yes. The biggest risk of an untreated stone is blockage of the kidney. If left unattended, the kidney will eventually die off and be permanently damaged.
Infection can also occur in a blocked kidney and make you really unwell.
“Once a stone former, always a stone former”. About half of the patients suffer from repeated stone attacks within 5 years.
We place a strong emphasis on dietary and fundamental lifestyle changes as part of our end-to-end holistic management of stone patients to reduce the risk of further stone attacks.
No single step prevents every stone, but recurrence can be reduced significantly. Keep your urine dilute by drinking enough water through the day, limit sodium and animal protein, keep a balanced calcium intake and pair high-oxalate foods with calcium-rich foods.
If you have had more than one stone, your urologist may recommend stone analysis and a 24-hour urine test so that prevention can be tailored to your stone type.
Water is the most important drink. Aim to drink enough through the day to keep your urine pale, and more in hot weather or when exercising. Limit sugary and caffeinated drinks, which can increase calcium excretion and dehydration.
Drinks alone will not dissolve most stones. If you have pain, fever or difficulty passing urine, see a urologist rather than relying on fluids.
