Ureteral Stones: Symptoms, Causes & Treatment

Ureteral stones are stones that originally form in the kidney then move and travel to the ureter, the thin tube that carries urine from the kidney to the bladder. When the stone lodges in the ureter and obstructs the passage of urine, blockage and pressure occur behind the stone, causing very severe pain known as renal colic, considered among the most severe types of pain a person may experience.

Stones usually form when urine becomes concentrated and certain salts and minerals precipitate in it, gathering and crystallizing. The chances of forming them increase with low water intake (the most important factor, especially in hot climates), some diets, obesity, family history, and some medical conditions. The symptoms of ureteral stones are characterized by pain coming in acute waves in the flank or lower back on one side, possibly extending to the lower abdomen and genital area as the stone moves, with the patient often unable to find a comfortable position. The pain is often accompanied by nausea and vomiting, blood in the urine (which may be microscopic), and burning or urgency in urination as the stone approaches the bladder.

The doctor diagnoses ureteral stones by the characteristic symptoms, a urine test, and imaging (often CT scan or ultrasound) to determine the stone's location, size, and degree of obstruction. Treatment depends greatly on the stone's size and location: small stones often pass on their own with urine within days to weeks, helped by drinking plenty of water, painkillers, and sometimes medications that help the stone pass and relieve the colic. Large stones, or those that do not pass or cause severe obstruction or infection, need intervention to remove them, such as fragmenting them with shock waves from outside the body, or endoscopy through the urinary tract to fragment and extract them. It is important to know that a stone with fever and chills (a sign of infection with obstruction) is an emergency requiring immediate care. Preventing recurrence of stones relies mainly on drinking plenty of water and dietary modifications according to the stone type.

• Very severe pain in waves in the flank or lower back on one side.
• Pain extending to the lower abdomen and genital area as the stone moves.
• Nausea and vomiting, and blood in the urine.
• Burning or urgency in urination as the stone approaches the bladder.

• Low water intake and concentrated urine (the most important factor, especially in hot climates).
• Precipitation and crystallization of certain salts and minerals.
• Obesity, some diets, family history, and some medical conditions.

• The characteristic symptoms (renal colic) and a urine test.
• Imaging (CT scan or ultrasound) to determine the stone's location, size, and obstruction.
• Assessing kidney function and signs of infection.

Small stones

• Often pass on their own; drinking plenty of water, painkillers, and sometimes medications that help the stone pass help.

Large or obstructing stones

• Fragmenting them with shock waves from outside the body.
• Endoscopy through the urinary tract to fragment and extract them.

A stone with fever and chills is an emergency. This content is educational and does not replace consulting a urologist.

• Infection with obstruction (an emergency that may threaten the kidney).
• Impaired kidney function with prolonged obstruction.
• Recurrence of stones without prevention.

• Drinking plenty of water daily (the most important means, especially in the heat).
• Dietary modifications according to the stone type with the doctor's guidance.
• Follow-up for those with recurrent stones to identify the cause.