Management of Ureteral Stones
Ureteral stone disease is among the most painful and prevalent urologic conditions. Affecting up to 12% of men and 7% of women across the United States, stone disease is increasingly common due to modern dietary shifts, dehydration, and lifestyle factors.
When a kidney stone travels into the narrow ureter—the muscular tube connecting your kidney to your bladder—it can block urine flow and cause severe discomfort. The good news: most small stones pass naturally, and for those that do not, modern urology offers fast, minimally invasive, and highly effective options to make you stone-free.
At UroPartners, our board-certified urologists provide prompt, compassionate, and expert care across Chicagoland to manage stone pain, safely clear obstructions, and prevent future stone formation.

How does the urinary tract work under normal conditions?
Your urinary tract functions like a high-precision plumbing system. The kidneys filter waste and salts from the blood to produce urine. Urine continuously trickles through two 10- to 12-inch muscular tubes (the ureters) into the bladder, where it is stored until leaving the body through the urethra.
How does a ureteral stone form?
A stone begins as a microscopic crystal (most commonly calcium oxalate, though sometimes uric acid, struvite, or cystine) in the kidney. Over time, additional mineral layers deposit onto the crystal, growing into a hard stone.
When a stone slips out of the kidney and enters the narrow ureter (which is only about a quarter-inch wide), it can lodge in place. This obstruction causes the ureter to spasm and urine to back up into the kidney, swelling the organ and triggering sharp pain.
What are the signs of a problem?
Ureteral stone symptoms often start abruptly and can be excruciating. Common signs include:
- Sharp, Severe Pain: Intense, cramping pain in the back, side (flank), lower abdomen, or groin. Men may experience pain radiating down to the tip of the penis.
- Urinary Changes: Persistent urge to urinate, painful or burning urination, or feeling unable to empty your bladder completely.
- Hematuria (Blood in Urine): Urine appearing pink, red, or brownish.
- Nausea & Vomiting: Triggered by severe pain and shared nerve pathways between the kidneys and digestive tract.
Emergency Warning
If intense flank pain or blood in your urine is accompanied by fever, chills, or persistent vomiting, seek emergency urologic care immediately. A blocked ureter combined with an active urinary tract infection is a serious medical emergency requiring urgent relief.
How are ureteral stones diagnosed?
At UroPartners, accurate diagnostic imaging is essential for deciding whether a stone will pass on its own or requires intervention.
- Low-Dose CT Scan (Computed Tomography): The gold standard for stone evaluation. Fast, precise, and highly accurate, a non-contrast CT scan pinpoints the stone’s exact size, location, and density.
- Renal Ultrasound or X-Ray (KUB): Used for routine monitoring or in patients who need to avoid radiation.
- Urinalysis & Bloodwork: Evaluates kidney function, screens for infection, and measures key electrolyte levels.

Stone Size Matters
- Stones ≤ 5mm: Have a high likelihood (up to 90%) of passing spontaneously within 4 to 6 weeks with proper hydration and medication.
- Stones > 5mm: Are significantly less likely to pass on their own and frequently require medical management or procedure-based removal.
What are some treatment options?
Your UroPartners specialist will customize your treatment based on stone size, location, symptoms, and overall health.
1. Conservative Management & Medical Expulsive Therapy
If your stone is small, your pain is controlled, and there is no sign of infection or kidney damage, trial of passage is often the best first step:
- Increased Hydration: Drinking 2 to 3 quarts of water daily to help flush the stone downward.
- Pain & Nausea Control: Prescription anti-inflammatories or targeted pain medications to manage discomfort during spasms.
- Alpha-Blocker Therapy: Medications (such as tamsulosin) that relax the smooth muscle of the lower ureter, allowing stones to pass faster and with less pain.
If a stone fails to pass after 4 to 6 weeks, proactive treatment is recommended to prevent kidney damage.
2. Outpatient Minimally Invasive & Non-Invasive Procedures
When conservative measures aren't enough, UroPartners offers advanced outpatient interventions with rapid recovery times:
- Shock Wave Lithotripsy (ESWL®): A non-invasive option where focused acoustic shock waves pass harmlessly through the body to crumble the stone into sand-like fragments, which then pass naturally in your urine. Ideal for small-to-medium stones in the upper ureter or kidney.
- Ureteroscopy (URS) & Laser Lithotripsy: A flexible, ultra-thin scope is passed through the natural urinary pathways directly to the stone without any surgical incisions. A precise holmium laser vaporizes or breaks the stone into fragments, which are extracted with tiny baskets. A temporary temporary ureteral stent is often placed to keep the passage open during healing.
- Percutaneous Nephrolithotomy (PCNL): Reserved for very large, complex, or impacted stones. Performed through a tiny incision in the back, allowing direct access to fragment and extract large stone masses.
- Open Surgery: Extremely rare today and reserved exclusively for exceptional, highly complicated structural cases.

Preventing Future Stones
Without preventive care, roughly 50% of people who experience a kidney or ureteral stone will develop another within 5 years.
At UroPartners, care doesn't end when your stone passes. We perform stone composition analysis on retrieved fragments alongside 24-hour urine metabolic evaluations to identify why your body formed the stone. Based on your specific chemistry, your urologist will outline a tailored prevention plan—including custom dietary adjustments, fluid targets, and targeted preventive medications.
Content provided courtesy & permission of the American
Urological Association Foundation, and is current as of 5/2026.
Visit us at www.urologyhealth.org for additional information.