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The primary specialty that patients with suspected kidney stones should consult is the Urology clinic. The diagnosis and surgical treatment of all stone diseases involving the kidneys, urinary channels, bladder, and urinary system fall directly within the expertise of this department. For all urinary system problems ranging from severe flank pain to obstructive complications, examinations and radiological evaluations performed by a professional urologist are the most reliable path to rapid recovery. When sudden pain in the kidneys or changes in urine flow are noticed, consulting a urologist without delay is critically important for preserving kidney function and preventing the risk of permanent failure.
Which Department Should Be Consulted First When Kidney Stones Are Suspected?
Kidney stones generally do not cause major complaints as long as they remain stationary inside the kidney. However, when they move and enter the urinary channels, they may obstruct urine flow and lead to various health problems. People who suspect kidney stones, have previously passed a stone, or have a family history of stones should first consult the urology clinic. Urologists manage the entire process until urine is eliminated from the body. Since the kidney may become strained if an obstruction is not evaluated, consulting a urology specialist is important.
Which Doctor Should Be Consulted in Cases of Severe Flank Pain and Bleeding?
The main symptom that causes patients to visit the emergency department is sharp flank pain beginning in the kidney region and radiating toward the groin. This pain may occur when a stone obstructs the urinary channel. When this situation develops, a urology specialist or the emergency department should be consulted first. After pain-relieving interventions are performed in the emergency department, the patient is referred to the urology department for definitive treatment planning. Some common symptoms that may occur when a stone enters the urinary channel are as follows:
- Severe flank pain
- Blood in the urine
- Frequent urination
- Nausea
- Vomiting
Which Department Should Be Consulted for Mixed Symptoms Such as Abdominal Pain?
Kidney stone pain does not always appear only in the kidney region. Sometimes it may be felt as widespread pain affecting the entire abdomen and radiating toward the stomach. When kidney pain is accompanied by generalized abdominal pain and the source cannot be clearly identified, evaluating other body systems becomes important. Gallbladder problems or intestinal disorders may cause similar symptoms. In such cases, consulting internal medicine or general surgery for a general evaluation is an appropriate approach. If the tests reveal that the problem is a stone, the physician will refer the patient to the urology department.
Which Department Should Be Consulted If the Pain Is in the Back and Increases with Movement?
There is a common belief that every pain in the back and lower back region is associated with the kidneys. However, the characteristics of the pain help determine which physician should be consulted. If the pain increases with movement, bending, standing up, or lifting weight, it may indicate a musculoskeletal problem rather than a urological condition. Kidney stone pain does not improve with changes in position. For pain triggered by movement, making an appointment with physical medicine and rehabilitation or orthopedics may be more appropriate.
Which Doctor Should Be Consulted for Kidney Filtration Problems?
The nephrology department should be consulted for problems related to the kidney’s working capacity, filtration mechanism, and overall function. Nephrologists are physicians specialized in internal medicine. Unlike stone diseases, nephrological disorders may generally progress silently. If there is a problem with the kidney’s chemical filtration capacity or if kidney function tests in blood analyses are abnormal, the nephrology department should be consulted. Some conditions managed by nephrology are as follows:
- Foamy urine
- Swelling under the eyes
- Ankle edema
- High blood pressure
Which Department Should Be Consulted When Kidney Stones Are Suspected in Children?
Kidney stones may occur in children and infants, although they are rare. In children, stone symptoms may appear as restlessness, crying episodes, or abdominal pain rather than typical flank pain. Since children have narrower anatomical structures, diagnostic and treatment procedures require a delicate approach. In suspicious cases, families are advised to consult a pediatrician first. If tests identify a stone, pediatric urology specialists take over the intervention process.
Which Doctor Should Be Consulted for Kidney Stone Complaints During Pregnancy?
Pregnancy brings many changes to the expectant mother’s body. Kidney stone complaints may develop because the growing uterus compresses the urinary channels or due to metabolic changes during pregnancy. When kidney and groin pain occur during pregnancy, the obstetrician and gynecologist following the pregnancy should be informed first. After evaluating the condition, the obstetrician refers the mother to a urology specialist for treatment planning. The two departments work together throughout this process.
Which Department Provides Support for Determining the Size of the Stone?
One of the most critical steps in stone treatment is determining the stone’s location, size, and hardness. Urologists receive support from the radiology department to make this assessment. Ultrasonography or computed tomography performed by radiology specialists allows the stone to be mapped. Patients cannot apply directly to radiology and request treatment on their own. Imaging procedures are performed upon the urologist’s referral, and the results are evaluated by the urology physician to determine the treatment option.
Which Department Should Be Consulted to Prevent Stone Recurrence?
Stone disease may have a tendency to recur later in life. Patients whose treatment has been completed may remain at risk of developing new stones if they do not change their dietary habits. To control this risk, referring patients to a nutrition and dietetics specialist is highly beneficial. After the stone’s composition is analyzed, dietitians prepare a personalized nutrition plan. Some important points that should be incorporated into daily life during this process are as follows:
- Drinking plenty of water
- Restricting salt intake
- Reducing animal protein consumption
- Limiting foods containing oxalate
Which Department Should Be Consulted for Kidney Stone Problems in Older Adults?
When kidney stone complaints develop in older individuals, the treatment process may require more detailed planning. Since kidney function may naturally weaken with age and additional chronic conditions such as hypertension, heart disease, or diabetes are often present, urology alone may not be sufficient. Patients in this age group are advised to consult geriatrics or internal medicine before stone treatment so that their general health status can be examined comprehensively. Physicians from the relevant specialty evaluate organ functions and establish suitable conditions for the procedures. The active treatment process is then carried out under the leadership of urology specialists.
Which Urology Unit Should Be Consulted for Small Stones That May Pass Naturally?
If examinations indicate that the stone is very small and may pass spontaneously through the urinary tract, a conservative treatment plan is generally prepared. This follow-up process is managed through the hospital’s general urology clinic. The urologist prescribes medications that may help relax the urinary channels and painkillers, then schedules follow-up visits. Supported by abundant fluid intake and physical activity, this waiting period may allow the stone to pass naturally in many patients.
Which Units Should Be Consulted for Fragmentation of Medium-Sized Stones?
Non-surgical methods may be preferred for treating medium-sized stones located inside the kidney or in the upper sections of the urinary channel. Patients considered suitable for this method are referred to the hospital’s stone fragmentation unit. In this unit, under the supervision of technicians, the device sends focused sound waves directly to the stone’s location without damaging surrounding tissues in an attempt to break it into smaller fragments. During this outpatient session, the stones are intended to be reduced to sand-like particles and pass naturally through the urine.
Which Surgical Unit Should Be Consulted for Ureteral Stones?
Stones that do not pass naturally or cannot be fragmented using external sound waves may require a more direct intervention. These patients are referred to the endourology units of the urology department. Semi-rigid medical devices are used for stones lodged in the urinary tract, while thin flexible instruments may be used for stones located inside the kidney. The stone is reached directly through the natural urinary channels without making an incision in the body. The stones may be fragmented using a laser, helping the patient recover within a short period.
Which Surgical Department Should Be Consulted for Very Large Kidney Stones?
When a kidney stone reaches a large size or becomes very hard, standard closed methods may not be sufficient. These patients may be referred to urology teams specializing in percutaneous stone surgery. Since removing very large stones through the natural channels may take a long time, the kidney is accessed through a very small opening created in the patient’s back. Large stones may be fragmented and removed using specialized devices. These surgical interventions may contribute to the treatment of high-volume stones.
Prof. Dr. Berkan Reşorlu, born in Ankara in 1979, completed his medical education at Ankara University between 1997 and 2003, and his specialization in urology at Ankara University Faculty of Medicine between 2003 and 2008. Academically, he received the title of associate professor in 2013 and professor in 2022.
He has conducted extensive case series studies in the field of endoscopic stone surgery, contributed surgeries performed on children under the age of 1 to the literature, and has gained international recognition with his stone scoring system and experimental surgical models.
