Urology · University Urology, PC · Knoxville, TN
Kidney Stones
Kidney stones are one of the most painful urologic conditions — and one of the most recurrent. University Urology offers same-day urgent evaluation, advanced minimally invasive treatment, and metabolic stone prevention programs to help patients stop forming stones.
About Kidney Stones
Understanding Kidney Stones
Kidney stones form when minerals in the urine crystallize and clump together in the kidney. They range from tiny grains to stones several centimeters across. Small stones often pass on their own; larger stones may require intervention.
When to seek urgent care
Severe flank or back pain radiating to the groin · Nausea and vomiting with pain · Fever with stone symptoms (requires urgent evaluation for infection) · Inability to urinate · Known single kidney with obstruction
Same-day evaluation available
University Urology reserves urgent appointment slots daily for patients with kidney stone pain. Call early in the day. If you have fever with your stone symptoms, call immediately — infected obstruction is a urologic emergency.
Fever + kidney stone symptoms = call us or go to the ER immediately
An obstructed kidney with infection (obstructive pyelonephritis) can progress to sepsis rapidly. This is a urologic emergency. Do not wait for a scheduled appointment — call (865) 305-9254 or go to the nearest emergency room.
Treatment Options
Kidney Stone Treatment at University Urology
Observation & Medical Expulsive Therapy
Small stones (<5 mm) have a high rate of spontaneous passage. Alpha-blockers relax the ureter to facilitate passage. Pain management and hydration support this approach.
Ureteroscopy (URS)
A small flexible scope is passed through the urethra and bladder to the stone. Laser energy (holmium or thulium fiber laser) fragments the stone. Performed as an outpatient procedure. The most common surgical treatment for ureteral and small kidney stones.
Shock Wave Lithotripsy (SWL)
Non-invasive sound wave energy breaks the stone into small fragments that pass in the urine. Best suited for smaller stones in the kidney or upper ureter.
Percutaneous Nephrolithotomy (PCNL)
A small incision in the back allows direct access to the kidney for removal of large or complex stones. University Urology offers mini-PCNL for reduced recovery time. Performed by our fellowship-trained endourologists.
Prevention
Stopping Recurrent Stone Formation
Kidney stones recur in up to 50% of patients within 5 years without intervention. Metabolic stone evaluation identifies the underlying cause of stone formation and guides targeted dietary and medical prevention.
24-Hour Urine Collection
Identifies specific metabolic abnormalities driving stone formation — including hypercalciuria, hyperoxaluria, hypocitraturia, and low urine volume. Results guide tailored prevention strategies.
Stone Analysis
Analyzing the chemical composition of a passed or retrieved stone determines the stone type (calcium oxalate, uric acid, struvite, cystine) and guides prevention recommendations.
Our Specialists
Kidney Stone Care at University Urology
All seven University Urology physicians and our advanced practice providers evaluate and treat kidney stones across all 11 East Tennessee locations. For complex stone disease — including large stone burden, recurrent stones, PCNL, and metabolic stone prevention — Drs. Pickens, Riedinger, and Angelle take the lead.
Common Questions
Frequently Asked Questions
How much water should I drink?
The goal is to produce at least 2.5 liters of urine per day. For most people that means drinking 3 liters (about 100 oz) of fluid daily, more in hot weather or with exercise. Lemonade (not lemonade mix — real lemon juice) contains citrate which helps prevent calcium oxalate stones.
My stone is 4mm. Will it pass on its own?
Stones under 5mm pass spontaneously about 70% of the time. The location matters — stones in the lower ureter pass more easily than those higher up. Your urologist will recommend observation with medical expulsive therapy or intervention based on size, location, and symptoms.
I keep forming stones. What can I do?
A metabolic stone evaluation — including a 24-hour urine collection and stone analysis — identifies the specific cause of your stone formation and allows us to target prevention with dietary changes and/or medication. Recurrent stone formation is very often preventable.
Kidney Stone Pain? We Have Same-Day Appointments.
Fellowship-trained endourologists available across 11 East Tennessee locations. Call early for same-day urgent evaluation.