What kind of stone do you have?
Stones have different compositions, and many contain a mixture. Analysis of a recovered stone helps identify the material and guide prevention. Appearance alone cannot establish your stone type.
Read the full guide →Home / Understanding Your Stone
Stones Unlocked: your visual stone guide
A lighter version of David Shusterman, MD’s kidney stone book: understand your stone, prepare for office ESWL and build a prevention plan.
Choose your next question
Original English-language artwork from Stones Unlocked. The explanation below is available in your selected language. Illustrations are educational, not patient scans or predictions of your result.
Why crystal structure matters
Calcium oxalate monohydrate and dihydrate contain different amounts of water in their crystal structure. They can respond differently to shockwaves. Your imaging and clinical assessment help establish ESWL suitability.
Read the full guide →Why a stone can hurt
Pain often comes from obstruction, pressure and stretching, with spasm also contributing. Less pain does not prove the stone has passed. Follow-up helps establish what happened.
Read the full guide →From guessing to seeing
Office ultrasound can help assess stones and swelling. CT may be needed to clarify size, location or an uncertain finding. The right study depends on the question; these illustrations are not real patient scans.
Read the full guide →The ESWL evaluation
We assess your actual stone and health before recommending office ESWL. Stone size, density, location, anatomy, infection and bleeding risk all matter. Bring existing imaging rather than trying to choose treatment from a chart.
Read the full guide →After a hospital visit
Bring your discharge instructions, imaging and medication list. We assess persistent symptoms and arrange a follow-up plan. A typical episode diagram shows possibilities, not a required sequence or a promise of passage.
Read the full guide →Save a stone for analysis
If you recover a stone, ask the office how to collect and deliver it for analysis. The result can help tailor prevention. Do not delay urgent care to collect a specimen.
Read the full guide →The 24-hour urine blueprint
For selected stone formers, a timed urine collection helps identify factors such as low urine volume or excess stone-forming substances. Follow the laboratory’s collection instructions. Your clinician interprets the results and chooses next steps.
Read the full guide →Diet as part of prevention
Focus on a practical plan matched to your stone and health. Sodium, dietary calcium, portions and selected oxalate sources may matter. Potassium-rich foods and fluid goals need adjustment when kidney or heart conditions impose limits.
Read the full guide →Read the serving size
Compare sodium and portions before choosing packaged foods. The book’s product labels are illustrative examples, not verified products. A healthy-looking package does not guarantee a low-sodium serving.
Read the full guide →Confirm progress, then prevent recurrence
Stone analysis, selected urine testing, dietary changes and follow-up imaging can support a continuing plan. Testing and intervals are individualized. A roadmap is a guide to follow-up, not a guarantee of remaining stone-free.
Read the full guide →When your history needs a closer look
Repeated stones, a solitary kidney, kidney disease, infection stones or a strong family history can change the evaluation. Tell us about prior episodes and existing conditions so prevention fits your situation.
Read the full guide →Hidden stones and silent blockage
Some kidney stones cause no symptoms while they remain in the kidney. They may grow or move later. Persistent ureteral blockage can damage kidney function even when pain improves; the risk depends on its severity and duration. Evaluation and selected follow-up imaging help identify an unresolved stone or blockage.
Read the full guide →Follow a ureteral stone until resolution
Passage depends on size, location and your clinical situation. Observation or prescribed medication needs a time limit and follow-up plan. If you did not capture the stone, imaging may be needed to confirm resolution. Do not force fluids during acute obstruction or assume that pain relief means passage.
Read the full guide →Food choices that fit your stone
For many calcium stone formers, keep normal dietary calcium with meals rather than eliminating it; suitable yogurt or milk can help. Compare sodium in soups, sauces and packaged foods. If oxalate is high, review portions of spinach, nuts and rhubarb with your clinician. Moderate animal protein when indicated. Choose water as your main drink and individualize fluid goals if you have restrictions.
Read the full guide →Adapted from Stones Unlocked by David Shusterman, MD. Treatment and prevention are individualized.
Come in for a kidney stone evaluation
Bring your imaging and hospital records. We review your stone’s size, location and density, your symptoms and your health, then recommend a plan. ESWL suitability and timing are individual.
(212) 991-9991Urgent appointments. A considered treatment plan.
We offer urgent kidney stone appointments and can assess you for expedited office lithotripsy when appropriate. Call first: timing depends on clinical urgency, imaging, preparation and availability. An appointment is confirmed by our team.
Help the stone pass when it is safe
A procedure is not always the next step. For suitable ureteral stones, we may recommend observation, pain control and tamsulosin (Flomax) to support passage, with a defined follow-up plan. This use is off-label; benefit varies by stone size and location. Medication does not guarantee passage, and infection, persistent blockage or worsening kidney function can require urgent intervention.
Office pain relief and anesthesia
IV ketorolac (Toradol) is available for appropriate patients after assessment of kidney function, hydration and bleeding risk. It provides temporary pain relief; it does not remove a stone or prove that blockage resolved. Office ESWL includes an individual anesthesia plan.
Confirm passage. Plan prevention.
We review hospital records and imaging, perform office ultrasound and arrange CT when needed. Follow-up helps establish whether the stone passed or remains a problem. Stone analysis, dietary counseling and 24-hour urine testing can guide prevention.