Ask us: How will I know when a stone has dropped into the bladder?

In our “Ask a kidney stone doctor” section, we field questions from stone formers or their family members. Today’s question is about knowing when a stone has passed successfully. See other questions and answers or ask your own question here.

July 26, 2011

Question from a stone former actively passing a stone:

I have been diagnosed with a kidney stone.  I am experiencing pain that has now moved to my side.  Occasionally I will get waves of overall abdominal pain, but the sharp pains are still generally located to the side.  How will I be able to tell when the stone has dropped to the bladder?
I’ve been drinking 4L of water (at least) a day for 8 days now and the stone still has not passed. I would rather now go into work and keep on with my life until the stone passes – I am just concerned with knowing the warning signs of when the stone is very close to passing.

 

Answer:

During stone episodes, stones generally cause a predictable sequence
of symptoms as they move down the ureter. Initially, pain is located
in the back when the stone is located up near the kidney. As the stone
moves further down, the pain can also be located in the side and in
the abdomen. When the stone is in the lower part of the ureter, the
pain moves toward the front of the abdomen. Once a stone is entering
into the bladder, patients may also feel the urgency to urinate and
can feel pain in the groin. Once the stone makes it into the bladder,
there should be a relief of pain. While this sequence is typical, some
patients may experience different symptoms. We have more information
on this on our “What causes kidney stone pain?” page.

Staying hydrated is a good idea but it is not clear if it speeds the
passage of stones (make sure though to not drink more than about 1
liter in an hour, as water intoxication can occur with intakes of 2
liters an hour or higher). Use of certain medications, such as
tamsulosin, does appear to shorten stone passage. You should know
though that use of this medication for this purpose is “off label” and
should be discussed with your treating physician. Other factors that
influence the likelihood and speed of stone passage includes the size
of the stone and its location. Stones can take up to 6-8 weeks to
pass. If they have not passed by then, treatment may be required.

 

Before making any medical decisions, always consult with your treating physician.

About Dr. Mike Nguyen

Mike M Nguyen, MD, MPH, is a urologist and an Associate Professor of Clinical Urology at the Keck School of Medicine of USC in Los Angeles, CA. He specializes in the treatment of kidney stones with both surgery and dietary prevention and the in the treatment of kidney and prostate cancer using the latest robotic and laparoscopic surgical approaches. He sees patients patients at USC-Keck urology clinics located in Los Angeles, Pasadena, and La Canada, CA. He is the founder of the www.KidneyStoners.org website.
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14 Responses to Ask us: How will I know when a stone has dropped into the bladder?

  1. Rey says:

    The pain i’m feeling right now is at the side of my abdomen. So does it mean that the stone is in my ureter now? Thank you.

  2. deep ghosh says:

    How is a laser tretment done for removing stone from kidney size 4mm ?

    • Emily says:

      I had the laser treatment done first off I got 3 stones when I was pregnant and I learned what I can and cannot eat or drink certain foods or drinks caused a lot of pain every time I was in pain I’d drink more water and eat more salads well every year for 5 years I had to keep going to the ER and they would tell me the same thing that it should pass and drink more water well one day I was in a lot of pain and it was a different kind of pain I had chills I was weak couldn’t eat or drink without throwing it up no matter how hungry I was so I ended up going to the er and was admitted for a week they told me that I had the same kidney stones that I had 5 years earlier that they just grew and there was no way if pass them and they don’t know why someone told me I would because they were 10mm which is huge well I had a bladder infection a kidney infection and another infection I forgot what it was but anyway my kidney was 3xs the normal size and I was put on A LOT of meds and the stone had blocked my ureter tub so I went to a urologist and made an appointment he said it was the worst he’s ever seen and he has done his job for over 10 years usually the 1st visit is where they talk to you about options but for me he rushed me in for the surgery and he said I was close to death I looked horrible and he’s never had to rush someone in he didn’t even believe my story until he saw the ex rays so I went in they give u a cap and gown they put you asleep and when I woke up I was in constant pain because I had a stint in to prevent my ureter tube from closing and a catheter in and well you’ll be in pain until booth are removed which is aprx a week

  3. deep ghosh says:

    How is a laser tretment done for removing stone from kidney size 4mm ?is it painless??

  4. deep ghosh says:

    How shud i remove 4mm calculi stone from my right kidney,4months back it was 3.45mm as now its grown to 4mm m very tensed n worried ?is there ne medicine that cud pass out this stone or any painless treatment??

  5. shanks says:

    I have a 5mm stone that has moved to bladder. Am on pain killers and chinese herbal medicines.trying to avoid procedure

  6. Sherri says:

    I have a 16mm stone that was blocking my right kidney. I had a stent placed 4 days ago and will be scheduled for ESWL soon. Very frustrated with learning that the procedure will probable have to be repeated several times to break up the stone. My doctor said that I was not a candidate for the laser treatment due to where and size of the stone and does not recommend surgical removal. I do not want to keep on repeating the shock wave procedure and suffer with continual pain trying to hopefully pass the fragments. I want this stone out now! I understand surgery is a drastic option but Wouldn’t surgery be a better option to get rid of the problem all at once? I have never had a stone before and want this thing removed.

    • Abhilash says:

      Please try homeopathy, it is working for me, i am having 1.6 cm stone in my kidney and 5 mm in the ureter, now passed the 5 mm without any pain and doctor told that 1.6 cm stone will be able to pass after getting it broken into minute particles, i will not recommend homeopathy if its an emergency case, I am able to cope up with the pain as its not that much severe (at first it was with vomiting too), I am waiting for more stones to pass.

  7. sujit says:

    I had a kidney stone of size 15mm in my right kidney, I came to know it after the ultrasound process when I have at the time of my terrible back pain. the doctor suggest me to take medicine and I have the medicine. now I do not have any pain. so how will I know whether my kidney stone pass away or not. if not what step should I take?

  8. Lou says:

    I have had several but the one I have now is the worst since the first 15 years ago. Lot of pain getting into the urters , but it has stalled entering the bladder , 6 weeks, lot of penal pain. 2cm, going back next week, if it hasn’t moved surgery, very scared of the stent….cysocopy, was horrible

  9. Adrian says:

    In June, a CT scan spotted a 5mm stone at the exit to my left kidney. I took Tamsulosin and around 4 weeks later I’d passed the stone. I hadn’t felt the stone move so was convinced it was still in my kidney and I’d need surgery. On the evening before I passed the stone, I had discomfort in my groin, an urgency to pee and a tightening and relaxing of my penis. This eased up after a while. When I had a pee it was obvious there was a partial obstruction which I’m guessing was around the prostate area. I took prescription pain killers and compatible anti-inflamatories and went to bed. In the morning I knew what was going to happen – some pressure, discomfort and out popped the stone. I couldn’t believe the lack of pain between June and when the stone appeared at the end of July. I’d had a lot of pain and blood in the previous 6 months which my doctor thought was associated with a couple of smaller stones. The 4.5mm stone I had 10 years ago was a nightmare so I know I got off very lightly this time.

    • Charlene Crosthwaite says:

      I can relate to your problem. I’ve passed a total of six stones. Two were in the area of my bladder when found, but a larger stone 1.7 centimeter completely blocked my left ureter, so the pain was extremely intense. Had lots of previous pain apparently while the stones made their way down ahead of the large stone. The position was told to me by ER doctor. Next morning before having a stent inserted, I passed the two small stones. That was on Friday morning. Pain continued over the weekend, but not nearly as bad. On Monday three more small stones passed. Had two lithotripies done to break up the large stones. Shortly after, I had the stent removed and actually passed the largest stone to date (the size of a pea). That one actually burned a lot upon passing. Probably because the stent had been removed earlier in the day. I was thankful that the doctor suggested taking pain pills left over from the second lithotripsy. Stones still remain in the kidney and I’m hoping they stay where they are, in the lower pole of my kidney. X-ray next month will tell for sure.
      I also stayed extremely hydrated, lots of lemonade and flavored waters. I really do think that helped a lot. But would really just like to hear they’re all gone!

  10. Rajendra says:

    IHave the kidney stone in my kidn

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