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?”
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.