Medical Director & Consultant Urologist
MBBS (Singapore), MRCS (Edin) FRCS-Urol (Glas), FAMS (Urol)
Kidney stones are relatively common in Singapore and across Southeast Asia, with an estimated lifetime risk of over 10% among the local population. In addition, Singapore lies within a global “stone belt”, where hot and humid climates increase the risk of dehydration, a key factor in stone formation. Diets high in salt and animal protein, along with increasingly sedentary lifestyles, may also contribute to this risk.
As a result, the incidence of kidney stones appears to be rising. This trend may be linked to changes in diet, higher rates of obesity and metabolic conditions, as well as improved detection through modern imaging. For individuals at risk, kidney stones can present in different ways, depending on their size, location and underlying cause.
Kidney stones are hard deposits made of minerals and salts that form within the kidneys. They develop when substances such as calcium, oxalate or uric acid become concentrated in the urine and crystallise. These stones can vary in size, from small grains to larger masses, and may remain in the kidney or travel through the urinary tract, potentially causing pain and other symptoms.
Kidney stones are classified based on their composition, which can influence both their causes and management. The main types include:
The most common type, usually formed from calcium oxalate or calcium phosphate. They are often linked to dietary factors, dehydration or metabolic conditions.
These form when urine is too acidic and are commonly associated with high protein diets, gout or certain metabolic disorders.
Typically develop in response to urinary tract infections and can grow quickly, sometimes becoming quite large.
These stones are rare and form when there is an excess of cystine in the urine. They are often associated with inherited disorders.
Kidney stones can develop due to a combination of dietary, lifestyle and medical factors that affect the composition of urine. Common causes and risk factors include:
Not drinking enough fluids can lead to concentrated urine, promoting stone formation.
Excessive salt intake can increase urine concentration and promote stone growth.
A personal or family history of kidney stones increases the risk of recurrence.
Conditions such as gout, hyperparathyroidism and certain digestive disorders can raise the risk.
Some medications and excessive intake of supplements like calcium or vitamin C may contribute to stone formation.
Higher body weight is associated with changes in urine composition that promote stone development.
Frequent infections can increase the risk of certain types of stones, particularly struvite stones.
Kidney stones may not always cause symptoms, especially when they are small and remain within the kidney. However, when a stone moves into the urinary tract, it can lead to a range of symptoms, including:
Kidney stones are diagnosed through a combination of clinical assessment and investigations to confirm their presence, determine their size and location, and identify any underlying causes. This typically begins with a review of your symptoms, medical history and risk factors, along with a physical examination. Further tests may include:
Urinalysis can detect blood, crystals or signs of infection, while specialised tests may assess substances that contribute to stone formation.
These help evaluate kidney function and identify abnormalities such as high calcium or uric acid levels.
Imaging tests such as ultrasound, X-rays or CT scans are used to locate the stone and assess its size and position within the urinary tract.
Treatment for kidney stones depends on factors such as the size, location and composition of the stone, as well as the severity of symptoms. Management ranges from conservative approaches to minimally invasive procedures and surgery.
Small stones may pass on their own with adequate hydration and pain relief. Medications may also be prescribed to help relax the urinary tract and facilitate stone passage.
For stones that are unlikely to pass or are causing significant symptoms, procedures such as extracorporeal shock wave lithotripsy (ESWL) or ureteroscopy with laser fragmentation may be recommended.
Larger or more complex stones may require surgical removal, such as percutaneous nephrolithotomy (PCNL), which involves accessing the kidney through a small incision in the back.
Preventing kidney stones focuses on reducing the risk of crystal formation in the urine through lifestyle and, in some cases, medical measures. Strategies are often tailored based on the type of stone and underlying risk factors.
Qualifications & Credentials:
Dr Jonathan Teo is a fellowship-trained consultant urologist in Singapore with extensive expertise in men’s health, urological cancers, and minimally invasive treatments. He was formerly the Director of Andrology at Singapore General Hospital and an elected EXCO member of the Society of Men’s Health Singapore. Dr Teo specialises in erectile dysfunction, kidney stones, male subfertility, and advanced treatments for benign prostatic hyperplasia (BPH).
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