Ask us: Treatment options for a 6mm kidney stone

In our “Ask a kidney stone doctor” section, we field questions from stone formers or their family members. See other questions and answers or ask your own question here.


January 10, 2012

Question about treatment options for a 6mm kidney stone:

“About 10 years ago, I had a kidney stone that passed over the course of a few days.  It was also on the right side, but I never found out how big it was or what kind of stone it was.

I recently had severe pain on the right side of my back for a few hours.  The pain went away.  I had a CT Scan of my Urinary Tract which revealed:

“There is a right ureteric calclus measuring 3mm in diameter at the level o the L4/L5 intervertebral disc.  There is mild prominence of the right pelvicalyceal system and proximal ureter above this.  There is no other reteric calculus but the is a 6m calculus in the right lower pole calyx.  The kidneys are otherwise normal in appearance.  The other solid viscera of the upper abdomen are normal allowing for the non contrast study. Conclusion: 3mm mid right ureteric calculus, with mild prominence of the right ureter superior to this.  second non obstructive calculus in right lower pole calyx.”

I don’t know if the 3mm stone has passed yet. I only have intermittent very slight aching on the right side of my back. I am more worried about the 6 mm stone. What would be the best treatment for the 6mm stone?  I have read that stones in the lower pole can be more difficult to successfully blast. Would blasting be an option? What are the chances it will pass on its own?  Is there anything I can do to encourage it to pass on its own safely?  If I do nothing, what is the likelihood it will remain asymptomatic indefinitely?  Is watch and wait a safe option for me? ”


First step is to make certain you pass the 3mm stone. If you don’t pass it then you could undergo ureteroscopy and the 6mm stone could be addressed at the same setting.

Next, on the CT one would measure the stone density and skin to stone distance. This would further guide us as to whether shockwave would work. For a 6mm stone in the lower pole success with shockwave would be 70% if the density and distance were favorable. Other options are to observe the stone if it is not causing pain or ureteroscopy which has a 90% success but is more invasive.

A previous question on our website may be of interest to you when considering observing the stone. While the question then was about a 3mm stone, the information also applies to a 6mm stone such as yours.

(UPDATE 1/11/12) Additional comments from Dr. Marshall Stoller: I would also bring to light that your stones have always been on your right side.  We have undertaken some studies that have shown most patients with recurrent unilateral stones sleep stone side down. Studies have shown dramatic changes in renal blood flow resulting in a hyperfiltration phenomenon.  I would recommend that you attempt to change your sleep posture, if indeed you do sleep on your right side. Additionally, I would reduce your sodium intake, reduce animal protein consumption at individual meals, and ensure that you drink enough fluids to void >1.5 liters per day.

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 their local medical professional.

About Dr. Manoj Monga

Manoj Monga, MD, is a Professor of Urology at the Cleveland Clinic Foundation, in Cleveland, Ohio.
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58 Responses to Ask us: Treatment options for a 6mm kidney stone

  1. Sameer says:

    I have a 5.1*8.7 mm stone in my right upper ureter , will it pass through urine. Please suggest.

  2. Asp says:

    Have a 6mm kidney stone diagnosed by ultrasound. Am pre-diabetic. And overweight. My pcp said he wanted it to grow bigger. I am terrified. Been crying about it for days. It did at one time shoot straight down my ureter to the area of my apendix, without much pain and then it faster than lightening went back up into my kidney. The stone I was told was nonobstructive. What do I? I’m scared I’ll need a stent. What proceedure is new best for me? Please help. Can it pass on it’s own? I recently passed a 5mm stone. Of I need a stent then what can I take for the pain of that? Should I stop drinking spring water and milk? My pcp told me to stop. I get aches every once in awhile and then they stop. Also all my stones have been staghorn.

  3. salman says:

    there z a 5 mm stone in the distal right ureter just proximal to the junction secondary minimal hydronephrosis…. final report of CT scan . treatment plzzz

    • Dr AUTh says:

      My advice first to be seen by urologist or emergency physician, if renal function is normal then you have to take diclofenac sodium ( dose depend on the weight) at least for 2 days , tamsolucin 0.4mg po once daily at bedtime for 2 weeks, paracetamol 1g per oral every 6 hours at least in the first 2 days, watch your urine because there is a very high chance that stone will pass by itself . If you still in pain despite all the above mentioned management then you need ureteroscopy + removal of stone by either laser or pneumatic litho trips.

  4. Jigar pandya says:

    In my lower abdomen left saide Stone is diagnoses .my left kidney is near pelvic. What’s tretment.

  5. Pritesh N.Vandarwala says:

    I m 24 year old person.I m from Gujarat.I have two culculi(one is 7.1mm and second is 3mm in size in lower calyx of left kedney.)what treatment is best for me?pcnl or other?

  6. samir das says:

    my brother’s wife have 9.3 mm calculus,36 mm away left VUj
    please give me you valuable suggest

  7. John says:

    Dear Sir,

    My mother(53 yrs) CT scan report.
    – evidence of 5mm non obstructive calculus in lower calyx of right kidney.

    request you to please suggest me what to do.

  8. salman says:

    Hello sir my name is salman I have 12 mml stone in my right kidney in urine pipe kindly guide me I’m very confuse .

  9. dr. akash patel says:

    Dear sir
    This is dr.akash from father is having severe abdo pain nd vomitting since last night…usg done in morning shows vuj calculus left side with mild hydronephrosis nd hydroureter…kindly suggest further management..

  10. leena kamlesh. suthar says:

    My wife have 6 mm stone in uterus.left kidney.2mm&4mm in right side kidney.suggest

  11. bhanupriya says:

    Sir my husband is having 4 mm stone in right kidneyatt mid pole since 1 year.many medicines have been taken plz helpme sir. Thanku

  12. Tucker says:

    Have stone 6mm. Anything over 4mm is not likely to exit. Go to the doctor if your in pain more than 10 days or you can permanently damage your kidney.

  13. rajender d says:

    i have 7mm uvj calculas and mild urethronisis..
    and …
    left rena lower clx 5mm calculas
    please say suggest is
    passs it the urine way

  14. Kamal pandey says:

    I have 6 mm. Kidney stone and i have many treatments about this but no result

  15. Sami says:

    I have a 6mm UVJ calculus in Lift/kidney. I am suffering from severe pain in urethra from last one month and take following medicine from last 12-days suggest me what to do please:
    1.Tab: Capval 500mg
    2. Tab: Prostate 0.4mg
    3. Tab: Denzen D

  16. Lakshmana shiva says:

    Hi Sir,
    My father aged 49 years old.he is affected by kidney stone.when scanning is done we got result of 13*6 mm calculus in right kidney below 10cm pelvic ureteric.can u suggest any good treatment.

  17. Mamta says:

    My husband have 6mm kidney stone on the right side feeling severe pain. can it be passed without surgery. pain. Please tell what to do. Thanks!

  18. Ravinder says:

    My wife is 23 weeks pregnent and she have stone of size approximate 2 mm at mid calyx with mild increase echogenicity in right kidney.
    She face lot of pain of stone during pregnency.
    Please tell me treatment

  19. Jugal Sharma says:

    I have a 4 mm calculus in mid pole of right kidney & 4.6 mm in left kidney. I am suffering from severe pain past three days! Please suggest me what to do

  20. Javed says:

    I have 6mm kidney stone on the right side feeling severe pain. What i have to do as i have began treatment from last week. Is drinking more water good for it or not? Thanks

    • Bill says:

      I just passed a 6mm stone. It took 3 weeks for it to block my urine flow. Once this happens, I recommend drinking aprox 30 ounces of water in stages. Drink the water and then wait till you urinate it all out till you drink again.
      This will keep your bladder from feeling like it’s going to explode as it normally takes time to pass . I find it better to pinch the tip of your penis and let the pressure build up to “inflate” the tube allowing more space for the stone to make it way through. While holding press it in and out and jiggling it as to facilitate the movement of the stone. Also I find it easier to stay relaxed while sitting down on the toilet.
      Stay calm, take a Valium or something to keep you calm if necessary.
      I hope this helps, I have passed many using this technique. Just keep in mind it is normal for this to take hours.

  21. Pierre Yaghi says:

    I have a 8.9mm calculus at the lower pole in my right kidney and two calculus measuring 8.0 and 6.0mm at the lower pole if the left kidney. I am suffering from a severe pain. Please tell what to do. Thanks!

  22. himanshu says:

    I have a 9mm calculus in upper ureter. I am suffering from severe pain past three days! Please suggest me what to do

    • JATIN P GAJERA says:

      I have a 6.0 mm calculus in mid pole of right kidney & 6.2 mm in left kidney. I am suffering from severe pain past three days! Please suggest me what to do

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