Brief Answer:
Read detail answer bellow.

Detailed Answer:
Hello
Thanks for your query,
Normally the following are the presenting symptoms of stone in the kidney.
1) Pain in the loin or abdomen on affected side or lower back if the stone is obstructed in ureter.The pain may be be a dull aching in nature if the stone is non obstructing.
2) Vomiting this is mostly due to reflex gastric irritation and indicates obstructive nature of stone
3) There may be fever if associated with infection (UTI)
4) Burning or frequent urge to pass urine this is common if the stone is located in lower part of ureter.
4) Blood in the urine (Hematuria).

The most important confirmative tests are
1) Routine urine teats and Culture
2) Ultrasound Scanning of the abdomen and pelvis .This is the most important tests and will indicate site and ,size of the the stone and degree of obstruction or back pressure changes in kidney and ureter proximal to the site of stone.(Hydronephrosis) which is deciding factor in modality of management of stone.

Hope I have answered your query ,please feel free to ask if you have more questions I shall be happy to help you
Thanks and Regards.
Dr.Patil.

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Brief Answer:
Need for surgery depends upon following factors.

Detailed Answer:
Hello
Thanks for follow up.
Need for surgery depend upon the following factors.
1) Large stone more than a size of 2 cms located in Kidney.
2) Impacted Stone in the ureter causing severe pain ,vomiting,fever suggesting infection
3) Severe grade 2-3 hydronephrosis caused by obstruction to urine flow from kidney into bladder due to stone and jeopardizing kidney function.
4) Stone of a size of less than 2 cms can be fragmented with the procedure called Extra Corporeal Shock Wave Lithotripsy.(ESWL).This is not a surgical procedure.

Thanks and Regards.
Dr.Patil.

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