Ureteric Stones: Symptoms, Diagnosis & Modern Treatment

Ureteric stones are a common and often extremely painful urinary problem. They occur when a stone formed in the kidney moves into the ureter—the narrow tube that carries urine from the kidney to the bladder. While some small stones may pass naturally, others can become stuck, block the flow of urine and cause severe pain or complications.

The right treatment depends on the size, location and nature of the stone, as well as the patient’s symptoms and overall urinary health. If you experience severe flank pain, blood in the urine or difficulty passing urine, timely evaluation by a qualified urologist in Agra can help determine the cause and appropriate treatment.

What Is a Ureteric Stone?

The urinary system consists of the kidneys, ureters, bladder and urethra. The kidneys filter the blood and produce urine, which travels through the ureters into the bladder.

Kidney stones develop when certain substances in the urine become concentrated and form crystals. A stone that moves from the kidney into the ureter is known as a ureteric or ureteral stone.

Because the ureter is relatively narrow, a stone may become lodged at different points along its path. This can obstruct urine flow and cause intense pain.

What Are the Symptoms of Ureteric Stones?

Symptoms can vary depending on the stone’s size, location and whether it is causing obstruction.

1. Severe Flank or Side Pain

One of the most characteristic symptoms is sudden, severe pain in the side or back. The pain may occur in waves and can be extremely intense.

2. Pain Moving Towards the Groin

As the stone travels down the ureter, pain may move from the back or side towards the lower abdomen or groin.

3. Blood in the Urine

A ureteric stone may irritate the urinary tract and cause blood to appear in the urine. The urine may look pink, red or brown, although sometimes blood is detectable only through a urine test.

4. Burning During Urination

When the stone moves closer to the bladder, some patients experience pain or a burning sensation while urinating.

5. Frequent Urination

You may feel the need to urinate more frequently, particularly when the stone is located in the lower part of the ureter.

6. Nausea and Vomiting

Severe stone pain can sometimes be accompanied by nausea and vomiting.

7. Fever and Chills

Fever or chills along with a urinary stone can indicate an associated infection.

A stone causing urinary obstruction together with infection can require urgent medical attention.

Why Do Ureteric Stones Develop?

Most ureteric stones initially form inside the kidney before moving into the ureter.

Several factors may increase the likelihood of urinary stone formation, including:

• Inadequate fluid intake
• Dehydration
• High salt intake
• Certain dietary patterns
• Family history of kidney stones
• Previous history of urinary stones
• Certain metabolic conditions
• Some medical conditions and medications
• High levels of stone-forming substances in the urine

Understanding the type and possible cause of recurrent stones can be useful in developing a prevention strategy.

How Are Ureteric Stones Diagnosed?

Proper diagnosis helps determine the location, size and degree of obstruction caused by the stone.

Medical History and Examination

The urologist may ask about the location and severity of pain, urinary symptoms, previous stones, medical conditions and medications.

Urine Tests

Urine examination may help identify blood, crystals or signs of urinary infection.

Blood Tests

Blood tests can be used to evaluate kidney function and other factors relevant to stone disease.

Ultrasound

Ultrasound can help identify stones and signs of urinary obstruction, such as swelling of the kidney.

CT Scan

A CT scan may provide detailed information about the stone’s exact location, size and urinary obstruction. The appropriate imaging investigation is selected according to the patient’s clinical situation.

Can a Ureteric Stone Pass Naturally?

Some ureteric stones can pass naturally through urine without surgical treatment.

The likelihood of spontaneous passage depends particularly on:

• Stone size
• Stone location
• Urinary anatomy
• Degree of obstruction
• Patient’s symptoms
• Presence or absence of infection

Smaller stones generally have a better chance of passing naturally than larger stones.

However, patients should not assume that every stone will pass on its own. Persistent obstruction can potentially affect kidney function.

Modern Treatment Options for Ureteric Stones

Treatment is individualized according to the characteristics of the stone and the patient’s condition.

1. Conservative Management

For selected small stones that are likely to pass naturally, the urologist may recommend observation along with appropriate medication and follow-up.

Pain-relieving medicines may be prescribed, and certain medications may be considered to facilitate stone passage in suitable patients.

Regular follow-up is important to ensure that the stone has passed and is not causing ongoing obstruction.

2. Ureteroscopy (URS)

Ureteroscopy or URS is a commonly used minimally invasive procedure for treating ureteric stones.

A thin instrument called a ureteroscope is passed through the natural urinary passage into the ureter. The surgeon can locate the stone directly.

Depending on the stone, it may be removed or fragmented into smaller pieces.

Because the procedure is performed through the urinary passage, it generally does not require an external surgical incision.

3. Laser Lithotripsy

Laser technology can be used during ureteroscopy to break a stone into very small fragments.

These fragments can then be removed or allowed to pass naturally, depending on the clinical situation.

Laser stone treatment can be particularly useful for stones that are unlikely to pass naturally or are causing significant symptoms.

4. RIRS

Retrograde Intrarenal Surgery (RIRS) is another minimally invasive endoscopic technique used primarily for stones located within the kidney and selected upper urinary tract stones.

A flexible endoscope is passed through the urinary tract to reach the stone, and laser energy can be used to fragment it.

The choice between URS, RIRS and other treatment approaches depends on the exact location and characteristics of the stone.

5. DJ Stent Placement

In certain situations, a DJ (Double-J) stent may be placed inside the ureter.

The stent helps maintain urine drainage between the kidney and bladder. It may be required temporarily when there is significant obstruction, following certain stone procedures or in other clinically appropriate situations.

Your urologist will advise when the stent should be removed.

When Does a Ureteric Stone Need Urgent Treatment?

Seek prompt medical attention if stone symptoms are accompanied by:

• Fever or chills
• Severe or uncontrolled pain
• Persistent vomiting
• Difficulty or inability to pass urine
• Signs of urinary infection
• Significant urinary obstruction
• Reduced kidney function

An obstructed urinary system associated with infection can become a medical emergency and should not be ignored.

How Can Ureteric Stones Be Prevented?

Stone prevention depends partly on the type and underlying cause of the stone.

General preventive measures may include:

Drink Adequate Water

Maintaining good hydration helps dilute the urine and may reduce the concentration of substances that form stones.

Reduce Excess Salt

High sodium intake can contribute to the risk of certain types of urinary stones. Reducing excessive salt consumption may therefore be beneficial.

Follow Individual Dietary Advice

Not every patient with kidney stones needs the same diet. Dietary recommendations may depend on the type of stone and the patient’s medical history.

Evaluate Recurrent Stones

People who repeatedly develop stones may benefit from additional investigations to identify metabolic or other underlying risk factors.

Why Timely Urological Evaluation Matters

Ignoring a ureteric stone simply because the pain temporarily disappears may not always be safe. Pain can improve even when a stone remains present or urinary obstruction persists.

Imaging and clinical evaluation can determine whether the stone has passed and whether the kidney is draining normally.

If you have persistent urinary stone symptoms or recurrent kidney stones, consultation with an experienced urologist in Agra can help determine whether observation, medication, URS, laser treatment, RIRS or another approach is appropriate.

Frequently Asked Questions

Is a ureteric stone the same as a kidney stone?

A ureteric stone usually begins as a kidney stone. Once the stone moves from the kidney into the ureter, it is referred to as a ureteric or ureteral stone.

Can ureteric stones pass without surgery?

Yes. Some smaller stones can pass naturally. The likelihood depends on their size, location and the patient’s clinical condition.

Is laser treatment for ureteric stones painful?

Laser fragmentation is generally performed as part of an endoscopic procedure under appropriate anaesthesia. Your urologist can explain what to expect before and after treatment.

How long does it take for a ureteric stone to pass?

There is no fixed duration. Passage time varies according to stone size, location and individual factors. Follow-up is important rather than waiting indefinitely for a stone to pass.

Can ureteric stones damage the kidney?

A stone that causes prolonged urinary obstruction can potentially affect kidney function. This is one reason persistent or complicated stones require appropriate medical evaluation.

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Consult Dr. Dilip Kumar Mishra

Dr. Dilip Kumar Mishra
MBBS, MS, MRCS (Edinburgh, UK)
MCh (Urology), FRLS (Japan), FICS (USA)

Urocare & Child Clinic

Bhawna Estate, H. No. 24, Babarpur Road, next to Nukkad Cafe, near Holy Public School, Sikandra, Agra, Uttar Pradesh – 282007

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