Ask KidneyStoners.org: Why do I still have pain after passing a stone?

In our “Ask KidneyStoners.org” section, we field questions from stone formers or their family members. See previous questions and answers here.

 

January 13, 2012.

Question about residual pain after passing a stone from a stone former in England, UK:

” I am 61 years old and have never had a kidney stone before last Saturday (almost 1 week ago). I was hit with sudden, excruciating pain in my kidney area. I went to hospital and was treated with pain meds and kept in over night. The pain was so bad that I thought I would pass out with it. The following day the pain had subsided and I had a full bladder CT scan (no medium used). The scan showed a swelling below the kidney, indicating that I had had a stone but that it had passed. The doctor could not see any sign of any more stones although the CT scan had not yet been reported by a radiologist. The problem is that I seem to have some dull pain still around the same kidney and fear it being another stone. I wonder if there would be some residual pain after passing a stone for a week or so? Or could it be more trouble?”

Answer:

The experience that you described is consistent with a stone episode and although a stone was not seen on your CT scan, it is not uncommon for patients to have already passed a stone by the time a CT scan is obtained. It is also not uncommon to have residual discomfort after a stone has passed. We aren’t aware of good data on this phenomenon but we have seen patients complain of mild discomfort for up to several weeks after passing a stone. This discomfort may be due to remaining inflammation or swelling in the ureter and kidney area and should resolve on its own.

There are also some less likely reasons why someone may have persistent pain. Some of these include:

1) A stone was “missed” on the CT: While CT scans are highly accurate for detecting stones, there are a few scenarios where a stone can go undetected. A CT that does not include images of the entire length of the ureter but that instead stops before reaching the bladder can miss a stone that is further down. Also, a stone in the lowest part of the ureter near the bladder can sometimes be confused for calcifications known as phleboliths that can look similar on a CT scan.

2) There was another cause for your pain, unrelated to stones: Congenital obstructions of the ureter, known as ureteropelvic junction obstructions, can cause pain similar to a stone episode and will demonstrate swelling in the kidney on a CT scan. However, other clues on the CT scan will usually allow your physicians to determine whether this scenario is a possibility. Other uncommon causes for kidney swelling and pain that may not be easy to detect with a non-contrast CT scan can include passing a blood clot or piece of kidney tissue down the ureter, having a scar or other obstruction of the ureter, and very rarely, having a tumor involving the ureter.

It would be advisable for you to followup with your physician to review the radiologist’s report. Some physicians, including most urologists, may also review the actual CT scan images. You can consult with your physician to determine whether a followup ultrasound or CT scan is necessary to insure that the swelling in the kidney resolves. It should resolve if what you had was actually a successfully passed stone.

Please note that this information is not intended to represent medical advice or professional opinion. Each patient’s case is unique and we recommend that all patients seek care with a local medical professional who can thoroughly review the circumstances and details of their case.

 

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87 Responses to Ask KidneyStoners.org: Why do I still have pain after passing a stone?

  1. Jose Fuentes says:

    Im currently trying to pass a kidney stone. First time. The pain has been unbelieveable. I thought I passed a stone last night but now I think it was just a blood clot. The pain came back around 4am. I also started getting constipation. I have no urge except to urinate. In currently taking Ketorolac 10mg every 6 hours. Im about to go to pharmacy and ask them about the constipation and something over the counter when the meds run out. Its only for 5 days.

  2. Imran Ahmad says:

    Following is CT SCAN of my cousin 48 years old (male). Plz suggest on this, he is in pain:

    CT SCAN KUB
    CLINICAL INFO: Patient has presented with 3 days h/o pain right lumbar region associated with
    nausea and single episode of vomiting.

    TECHNIUQE: 1.3 mm reconstructed images from a scan performed on GE Optima 660 128 Slice CT
    scan Freedom Edition (with low radiation & high definition mode) reviewed on AW/Vitrea workstation
    using different window and level settings. Non-contrast CT scan KUB is performed

    REPORT:

    Both kidneys are normal in size however lower poles of both kidneys are medially directed and
    fused anterior to aorta forming horseshoe configuration with anteriorly directed bilateral renal
    pelvis. There is mild dilatation of right pelvicalyceal system with mildly dilated right ureter
    throughout its length due to presence of a calculus measuring 5.6 mm in right distal ureter just
    before (6.9 mm away from) VUJ with CT attenuation ranging from 424-512 HU. Mild right
    periureteric stranding is noted. No nephrolithiasis or hydronephrosis is seen on left side. The
    perinephric fat on both sides is normal and regular with no evidence of stranding on left.
    Left ureter is normal with no evidence of any calculus or dilatation.
    Urinary bladder is normal.
    Infrarenal double IVC noted with left IVC draining into left renal vein.
    No other gross abdomino-pelvic pathology is appreciable within the confines of non contrast examination.

    IMPRESSION:

    Horseshoe kidneys with anteriorly directed bilateral renal pelvis. A 5.6 mm calculus in right
    distal ureter just before VUJ leading to upstream mild obstructive right hydronephroureter and
    mild right periureteric stranding.
    Infra renal double IVC noted with left IVC draining into left renal vein.
    Please correlate clinically.

    Transcribed by: SherAlam
    This is a digitally verified report by
    and does not require signatures
    Dr. Sana Kundi

  3. Pingback: Groin Pain After Passing Kidney Stone | Kidney infection treatment

  4. Lisa Gravley says:

    I passed 2 stones last month and now having same symptoms again, anyone know if this is normal for stones 2 come back so soon? My doc had me on soma 350 mg 3x a day, gave relief but pain was still present for 2weeks after passing them n now same symptoms are back!

    • Jose Fuentes says:

      I would find out what type it is. For me I have a suspision that it may be from uric acid. Every couple of years I get gout which is from excess uric acid. I may have to go on permanent medicine which might take care of it. If you have the same problem that would help you. If its from calcium there are some online kidney remedies you could google. Also change your diet by drinking more water, eating less salt and drinking lemonaide with real lemons. That will raise your citrate levels in the blood and may help prevent the stones. Good luck!

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