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 surgical approaches. He sees patients at clinics located in Los Angeles, Pasadena, and La Canada, CA. He is the founder of the www.KidneyStoners.org website.
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123 Responses to Ask us: How will I know when a stone has dropped into the bladder?

  1. Abe Kay says:

    To everyone who is suffering from kidney stones. READ THIS
    Before I begin my rant, I have a suggestion for those currently suffering through the pain of a passing stone – long hot showers would often help me (but when that didn’t work I used Oxycodone).

    A COMMON CAUSE OF KIDNEY STONES (I have read varying opinions of how common ranging from 20-50%) is caused by high calcium levels from hyperparathyroidism (a non malignant tumor of 1 or more parathyroids. Get your calcium and PTH (parathyroid hormone) levels checked. The parathyroids are 4 glands, about the size of a grain of rice, generally located on the corners of the thyroid, hence the name, para (next to) thyroid. They monitor calcium levels in the blood. When there is a tumor they can leech calcium out of your bones, causing Osteoporosis, kidney stones, heart failure & much more. For some reason my urologist never checked my levels, that’s why I’m here informing you.

    The following is for those who discover they have Hyperparathyroidism.
    Minor outpatient surgery called hyperparathyroidectamy (removal of the tumored parathyroid) CURES the problem. BUT due to the specific nature of the parathyroid you must use a surgeon who specializes in this surgery (choose someone who performs AT LEAST 50 per year [in NY Dr Sanford Dubner preforms more than 150 per year, the most in NY, i recommend him]).

    One more point (I have researched this to death) I would not recommend Dr Norman or the Norman Parathyroid center in Tampa. Good website (parathyroid.com) lots of information but keep in mind he’s trying to sell you and IMHO it’s not all true.

    From what i have found, neither Dr. Norman nor his surgeons are Endocrinologists and they are NOT board certified (huge red flag for me). Their claims of high success rates are based on the fact that there is no follow up so they don’t find out about those patients who’s veins collapsed due to their visually checking all 4 parathyroids. BTW I’m not saying don’t do this, i’m just suggesting you talk to your Dr. and or surgeon about the benefits of checking all 4, don’t rely on the info from a website on which every page states a disclaimer that what’s written is their opinion.

    I wish you all a speedy recovery.

  2. Joe says:

    Hi i had a 4mm stone and although i am nit getting the sharp pains i was getting – there is still residual pain and i am concerned. Ill be drinking ACV with water for a while to see if i can dislodge any residual material. I know it’s in my bladder – but just not sure if it will ever come out.

  3. kunal says:

    my right ureter is dilated due to the presence of 6.6 x 5.7 mm calculus at right vesico-ureteric junction.
    what should i do now…is the sone too large? weather it will be remove without surgery?

  4. Nic says:

    This is my experience with a 6mm stone…
    The left back flank pain began on April the 19, 2017 and lasted for about 24hrs. This initiated the first visit to ER. ER confirmed it was in all likelihood a stone base on blood and urine analysis. However, to be completely sure they recommended a CT scan. I declined because I was out of country at the time and did not want to complicate things with my insurance provider. I visited my doctor on the 20th of April.
    She referred me to X-Ray and Ultra-Sound and scheduled an appointment with Urologist on May 17, 2017.
    On April 23rd I had another painful attack on my left back flank, not as severe as the first round on the 19th but still painful.
    Went for the Ultra-Sound and X-Ray on Monday the 24th of April and found out the dimensions of my stone 6mm left Ureter and also 1 stone 2-3mm in right kidney.
    As I am writing this (May 10, 2017) I have not seen my Urologist, remember appointment is set for May 17, 2017 (Canadian healthcare system).
    There was no significant pain between the April 25 through May 3rd, only some discomfort in my back, scrotum, left testicle and bladder. On May the 3rd I began having the urge to pee chronically. This lasted for approximately 5 days but the urgency did lessen with each passing day. Also I should mention since finding out about the stone I have been drinking 5-8 liters of water daily.
    Yesterday, May 9th I passed the stone at around 5pm. It was anti climactic but nonetheless extremely happy. I have the stone and will present it to my Urologist on the 17th for analysis.

    Here is a brief summary of what I learned/experience:
    Drink lots of water
    Take Flomax to increase diameter of the plumbing
    I also began taking Chanca Piedra 500mg/day not entirely sure if this worked. However, I can tell you that most pictures of stones were jagged, mine was more rounded. Not sure if this is due to Chanca Piedra but I have read that they break down the stone. Regardless, I was grasping and thought I would try anything.
    The Ureter is 3mm in diameter and does not expand. The stone passing through the Ureter is the most painful part. Once the stone passes this tube its pretty much uneventful.
    When the stone is entering the bladder I felt a tremendous urge to pee like having a UTI without the fever, chills and body aches. Push through it and drink lots of water.
    When the stone enters the bladder its now a waiting game and the passing will be almost irrelevant.
    Also, I drank water with lemon in it occasionally based on what I have read in terms of Citric helping eliminate stones.
    I am a 46 year old male 5’11 weighing 195lbs.
    I am healthy otherwise and excise daily.
    I have had one stone 6 years ago and believe my stone was created by dehydration and too much protein. Of course I can’t prove this but believe this to be the case.
    I hope this provides info to others going through this situation. I know I found this website very helpful.

    • Sarah says:

      Not true that the ureter doesn’t expand. I had a 8 by 9mm stone in my ureter and the ER doctor said it most definitely can pass because the ureter expands. Flomax also helps.

    • Shell says:

      Nic, don’t complain about the Canadian Healthcare System! I’m living in California now and nursing a possible kidney stone. It took me forever to find a walkin clinic because they’ve all shut down (I live in San Jose!) and I didn’t want to go to the ER because the last time I went for an ovarian cyst they billed me nearly $10,000. Thankfully I have insurance so I only had to pay $3,000 for this visit in which the ultrasound tech couldn’t find my ovaries! This is not our first rodeo with the ER either. Last year my son had appendicitis and it took two ultrasounds and three visits to the ER to confirm was his GP & I already knew. Thankfully we caught it in time. In any case, just be thankful
      you can afford to go to the ER whenever you like! I’m sitting here drinking fluids like mad to avoid having to pay thousands to the crackpots down at one of the supposedly best hospitals here! And btw, I am an extremely fit healthy eater so I have no idea how I got a kidney stone.

    • Chris says:

      Thanks for the info. I was diagnosed with my first stone last week. Only 3mm. Pain for a full with a trip to the ER. I am now pain free since saturday but no stone unless I somehow missed. Was extremely curious why I was pain free and how long it could take hanging out in the bladder if in fact that’s where it was. This info helps!

  5. surendra says:

    I had stones in kidney two years ago.I drank water and passed out through urine but its still recurring.Fortunately, it passes out through urine but I am concerned about my kidney. Can anyone give an idea how do I know if stone is still in my kidney? Should I need to consult the doctor?

  6. Rudra says:

    I have a stone of size 11 mm 2 months back. Doctor told i should go for surgery. I did nt go for surgery. I am taking water and vulavulu telugu word water melon now it came to size 9mm but i am getting pain at the ribs. Can any body suggest me whether stone is moving or not

  7. Sara says:

    This is my third time having stones. The first time I wasn’t diagnosed and had no clue what was happening to me until I found a stone in my underwear after the pain had subsided. The second time I thought I had a UTI and went to the ER to receive a diagnosis of kidney stones, the largest being 5mm. (I was pregnant both times.) They told me it was stuck and the opening to the bladder and unlikely that I would pass it on my own. I went home and drank raw apple cider vinegar with my water, about a tablespoon in my jug every time I refilled and that sucker passed within 24 hours. I also had a lot of friends praying for me. So I can’t say enough about both. Thank God for the raw ACV, though. Chug that stuff with your water and pray to Jesus for mercy! Raw ACV is a godsend for kidney stone sufferers. I recommend drinking it in a glass of water at least once a day to keep the stones away, even after you pass them., it’s good for so many things. I got lazy once my stones passed and thought I was in the clear, but once you get stones once, your likelihood of getting them again increases. And here I am again. Prayers for you all who are miserable right now! It won’t last forever.

  8. VARGHESE JOY says:

    intaking sweet broomweed herb is the best cure naturally. can take it in morning for upto 7 days

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