ENMany people know kidney colic: sharp pain in the side that spreads to the groin, nausea, sometimes blood in the urine. Kidney stone treatment in Germany starts with three questions: what the stone is, where it sits and how much it blocks the flow of urine.
Many small stones pass on their own; the main methods for the rest need no incisions, and only large kidney stones call for a small puncture. This page covers urgent situations, diagnosis, methods, prevention, specialists and arrangements.
When a stone cannot wait
Get urgent help wherever you are if colic comes with fever and chills, painkillers do not relieve the pain, no urine is passed, or the stone blocks a single kidney. Fever suggests trapped infected urine, which can lead to blood poisoning. Doctors then first restore urine flow with a thin tube (stent) or a drain through the skin and remove the stone after the infection clears.
Without these signs there is time to plan tests and treatment calmly, including in Germany. If you are already in Germany or must travel urgently, see emergency treatment in Germany.
Diagnosis: size, position and composition
Low-dose CT without contrast shows a stone’s size and density most accurately; the European Association of Urology guidelines call it the gold standard. Ultrasound usually comes first, serves for follow-up and is the main method in pregnancy. Blood tests show kidney function and inflammation; urine tests show blood, infection and acidity.
A removed or passed stone is analysed, because prevention and medication depend on its composition. If stones recur, a 24-hour urine collection checks the body’s chemistry: too much calcium or uric acid helps stones grow, while citrate stops salts from crystallising, so too little citrate also raises the risk. Bring existing scans on disc.
How stones are removed: from watchful waiting to minimally invasive surgery
A small stone often passes on its own; others are broken up with shock waves or a laser, or removed through a puncture. While a stone moves down the ureter, a drug that relaxes the ureter can ease its way. Uric acid stones can sometimes be dissolved with medication that makes urine less acidic.
Extracorporeal shock wave lithotripsy (SWL) breaks the stone with shock waves sent through the skin, and the fragments pass with the urine. Adults usually need no general anaesthesia, only pain relief and sometimes light sedation. It does not suit every stone: hard stones break poorly, sessions may need repeating, and it is not used in pregnancy, bleeding disorders or untreated infection.
In ureteroscopy, a thin endoscope is passed through the urethra and bladder into the ureter; a flexible scope reaches the kidney itself (RIRS, retrograde intrarenal surgery). A laser breaks the stone and the fragments are removed. There are no incisions, but general anaesthesia is usual.
Percutaneous nephrolithotomy (PCNL) is for large kidney stones: the stone is broken up and removed through a small puncture in the back, a narrower one in mini-PCNL. There is no universal method: the choice depends on the size, density and position of the stone. After surgery a thin stent is sometimes left in the ureter for a few days or weeks.
Preventing new stones
Drinking enough and eating to suit the stone type lower the risk of new stones. Stones often come back: up to half of patients develop another stone within five years. Water sipped through the day is best; the doctor sets the amount. Diet follows test results, not internet advice: calcium from food is usually not restricted, but less salt and meat is advised.
If tests reveal a metabolic problem, the doctor may prescribe medication, such as citrate when levels are low or drugs that lower calcium or uric acid in the urine, and check the kidneys by ultrasound. A new stone can form even with careful prevention, so follow-up matters without symptoms too.
Frequently asked questions
Which is better: shock waves or laser?
No method is best for everyone; the stone decides. Shock waves need no endoscope and usually no general anaesthesia, but break hard stones less well and may need repeating. Laser ureteroscopy more often clears a stone from the ureter in one go but requires anaesthesia and sometimes a stent. Large kidney stones usually call for PCNL.
Does a stone that causes no symptoms need to be removed?
Not always. A small kidney stone that causes no pain and does not block urine is often just watched with regular ultrasound. Removal is advised if it grows, causes pain, bleeding or infections, or blocks the urine. Lifestyle counts too: frequent travellers or people whose job makes sudden colic dangerous may have it removed earlier.
Is anaesthesia needed to break up a stone?
Adults usually do not need general anaesthesia for shock wave lithotripsy, but ureteroscopy and PCNL are done under general or spinal anaesthesia. Lithotripsy uses painkillers and sometimes light sedation; children have it under general anaesthesia. With spinal anaesthesia the lower body is numb while the patient stays awake.
How much does stone removal in Germany cost?
The hospital’s estimate gives the exact amount once the urologist has seen the scans and chosen a method. The price depends on the method, anaesthesia, days in hospital, any repeat session or stent, and stone and metabolic tests, so two patients with the same diagnosis may pay different amounts. AlenMed obtains the estimate before the trip.
How AlenMed arranges kidney stone treatment
AlenMed finds a stone specialist and organises everything around the treatment. One such specialist is Dr. med. Alexander Kaspin, chief physician at Urologische Klinik München-Planegg: he has headed the clinic’s stone centre since 2018, and his main fields include mini-percutaneous kidney stone removal and flexible ureteroscopy. At München Klinik Bogenhausen, urology is headed by chief physician PD Dr. med. Atiqullah Aziz, whose fields include minimally invasive stone treatment and endourology.
Before the trip, AlenMed translates scans and reports and sends them to a urologist, so kidney stone treatment in Germany is planned before departure. From the documents the doctor says which method is likely to suit and whether surgery is needed. AlenMed then books the appointment, passes on the estimate, prepares the visa invitation and arranges transfer and an interpreter, all from its office in Munich; see arranging treatment in Germany.
After treatment, patients take home a report in their own language with the stone composition, what was done and how to prevent new stones. For other conditions, see urology in Germany.
This material is for information only and is not an offer. The treatment plan is decided by a doctor at an in-person consultation.
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