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

  1. charity caldwell says:

    I’m having the same problems, passed the stone 3 weeks ago, treated 3 rounds of antibiotic for uti, on the last antibiotic pill and still feel bladder pain & some back pain.. is this normal? & of course 2 weeks away from a urology consult

  2. delphine says:

    It was actually a relief to read many of these comments and feel more assured that my symptoms are, though horrific, “normal.” I first had a KS about 2 decades ago and recall the pain as excruciating then; ended up in ER, meds, passed the stone etc. Just had a recent double attack: got the left and radiating flank pain, small amt of blood in urine and then was certain the stone had passed. Only to have the pain come back stronger—If I had waited any longer I would not have been able to drive to the ER. CT scan showed a 4 mm stone. Nausea, wanting to vomit, unbelievable pain. It took 10 mg of morphine with 15 mg of toradol to get the pain under control. Released home with Flomax, narcotics (which was useless and cause more constipation and nausea.) I was told if the pain comes back in full force the “pills won’t help–you have to come in for more IV pain meds.” SO–more than 2 weeks later, the pain has continued but has been (barely) manageable with Q 4hr 650 mg Tylenol with 400 mg Motrin. I am guessing the stone has passed ? No clear indication, just gradual lessening/worsening of pain x 10 days. Supposed to have a follow up urologist–taking too long, I could be dead. The almost constant pain/discomfort (which seems to subside only to come back with a sudden vengeance is debilitating and dehumanizing. I’ve been trying various remedies: olive oil/water/lemon juice mixed; basil tea; can’t say what has really helped if anything. The struggle continues.

    • Trisha Hanley says:

      I basically had the first attack I have wver had with a kidney stone this past May. I have known that two stones were in the left kidney. Ut for 10 years they just sat there…quiet. Then, here we go. Driving to work I get a poling, flank pain that then escalates into full blown radiating flank and back pain with nausea and vomiting. I drive 45 minutes to the hospital where I live in case I was going to be admitted. Sure enough, 6.5mm stone popped out of the kidney and was stuck in the upper proximal ureter. I am given morphine and toradol to get inblocked and then I see a Urologist the next day. We decide to do ESWL and blast it in the ureter. I start to pee out smaller stones that total the big stone when it ended. When I go for a follow up CT Scan, what do we see? The stone. Aitting again in the proximal ureter but it seems smaller. This makes no sense so we start FloMax again and schedule a second ESWL. Well, before I get to this second stone blasting, this thing decides to move way down in the distal ureter and can no longer be treated with ESWL because of the location. The Urologist can do a Uteroscopy and back the stone out or we can try to flush it out with tons of fluids and FloMax. I opt to give it a week because I don’t really want the scopes and moreover…a stent! No f-in way! Well, this thing felt like a UTI, bladder pressure 24/7 and worse yet, timy waves of pain in the lower groin area as it made its way down. This was happening for three days solid. I went to work on Oxycodone and Advil to try to get through it. Thank GOD I have a corporate office job and someone to drive me to and from work! I am sitting at my desk and all of a sudden, I feel a very odd “whoosh” in my lower bladder area. Yup. It flew out of the lower ureter and plopped into the bladder. I drank a whole bottle of water amd then went to the restroom with my strainer. Boom….there it is. Hercules. A 5.5mm stone. If this was left from ESWL then the stone I had was at least 10mm total or this was the second stone they said was much smaller. I call BS. It wasn’t small at all. It is now one day after all stones are now gone. I feel so much better with the wxception of some very dull low flank pain. Very dull but I know its there. It is probably the swelling from the ureter since there was quite a bit of hydroureter when the stone was stick in there and we saw it on the scans. I am glad to be rid of this and hope to NEVER go through this again. OMG!!!

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