Ureteral stones — symptoms, flank pain and what should you do?

Medical author: Jakub Gondek, MD, urologist — subject to approval before publication · Editorial preparation: Wyspa Medycyny Przyjaznej Editorial Team · Medical review: Jakub Gondek, MD — to be confirmed before publication · Creation date: 10 July 2026 · Review date: to be completed after approval · Updated: 10 July 2026

This article is educational and does not replace a urology consultation or urgent medical care. Fever, chills, severe pain that does not improve after medication, vomiting, inability to pass urine, having only one kidney, pregnancy, marked weakness, fainting or suspected infection associated with a ureteral stone require urgent medical assessment.

Key information at a glance

• Ureteral stone disease means that a stone is located in the ureter — the tube that carries urine from the kidney to the bladder.
• The typical symptom is sudden, severe flank or lower-back pain, often radiating to the groin, testicle, labia or lower abdomen.
• The pain may be accompanied by nausea, vomiting, restlessness, sweating, frequent urinary urgency, burning during urination or blood in the urine.
• The absence of visible blood in the urine does not exclude a stone. Conversely, blood in the urine does not automatically mean stones and requires diagnostics.
• Fever and chills with suspected stones are warning signs because infection combined with impaired urine drainage may be an emergency.
• Not every flank pain is caused by stones. Similar symptoms may occur with kidney infection, appendicitis, gynaecological conditions, testicular torsion, spinal pain or other acute conditions.
• Diagnostics may include urinalysis, blood tests, urinary tract ultrasound, assessment of kidney obstruction and, in selected situations, computed tomography.
• Treatment depends on the size and location of the stone, the severity of pain, the presence of infection, kidney function, the number of functioning kidneys and the patient’s general condition.
• Small stones may pass spontaneously, but larger, impacted or infected stones and those causing obstruction may require a procedure.
• Drinking enormous amounts of water during acute renal colic is not a good way to “push” the stone through and may worsen pain when urine drainage is blocked.

Learn more about the specialist

Jakub Gondek, MD, is a urologist at Wyspa Medycyny Przyjaznej in Gdańsk. He diagnoses and treats disorders of the urinary and reproductive systems, including urinary problems, pain in the urinary tract area, suspected infections, haematuria and symptoms that may suggest stones or other urological conditions.

Meet Jakub Gondek, MD

Does this topic make sense for SEO, AI and Google Search?

Yes. Patients very often search for questions such as: “ureteral stone symptoms”, “flank pain stone in ureter”, “renal colic what to do”, “kidney pain radiating to groin”, “ureteral stone when to go to hospital”, “blood in urine kidney stone”, “will the stone pass on its own”, “ultrasound or CT for stones” and “urologist kidney stones Gdańsk”. This is a topic with strong medical intent that should educate patients while clearly highlighting warning signs.

For acute urological pain, E-E-A-T is particularly important: a medical author, an update date, sources, cautious wording, distinction between pain requiring a planned consultation and pain requiring urgent help, and clear information that stones should not be diagnosed solely on the basis of pain location.

What are ureteral stones?

Ureteral stone disease occurs when a stone — most often formed previously in the kidney — moves into the ureter. The ureter is a narrow tube that carries urine from the kidney to the bladder. If the stone becomes lodged in the ureter, it may obstruct urine flow, cause swelling of the kidney and trigger severe pain known as renal colic.

The pain does not result only from the stone “scratching” the ureter. Increased pressure above the obstruction, ureteral spasm and tissue irritation are also very important. Even a small stone may therefore cause severe symptoms if it becomes impacted in a narrow area.

A stone may be located in the upper, middle or lower ureter. The lower it moves, the more often the pain radiates to the groin, testicle, labia, bladder or urethra and produces symptoms resembling a bladder infection.

Renal colic — what does pain from a ureteral stone feel like?

Renal colic usually begins suddenly and may be extremely intense. Patients describe it as flank pain, kidney pain, lower-back pain or pain radiating to the groin. A characteristic feature is that the patient often cannot find a comfortable position — they walk around, fidget, sit down and stand up because changing position does not bring the relief typically seen with ordinary back pain.

Typical features of pain caused by ureteral stones include:

• sudden onset, often without a clear cause,
• severe flank or lower-back pain,
• radiation to the groin, testicle, labia, lower abdomen or urethra,
• wave-like pain — periods of worsening followed by temporary improvement,
• nausea and vomiting,
• sweating, pallor, restlessness and a feeling that the pain is “unbearable”,
• frequent urinary urgency when the stone is close to the bladder,
• burning during urination or passing small amounts of urine,
• blood in the urine — visible or detected only by urinalysis.

Does flank pain always mean a stone in the ureter?

No. Flank or lower-back pain may suggest stones, but it is not sufficient for diagnosis. Similar symptoms may be caused by other conditions, including some emergencies.

The differential diagnosis of flank pain includes:

• pyelonephritis,
• urinary tract infection,
• appendicitis,
• biliary colic or cholecystitis,
• acute gynaecological conditions, such as an ovarian cyst, ovarian torsion or ectopic pregnancy,
• testicular torsion in men with pain radiating to the scrotum,
• diverticulitis and bowel disease,
• spinal pain, sciatica or muscle tension,
• aortic aneurysm or other vascular disease, particularly in older patients with sudden severe pain.

If the pain is very severe, unusual, occurring for the first time, or accompanied by fever, fainting, vomiting, blood in the urine or deterioration in general health, self-diagnosis should be avoided.

When do ureteral stones require urgent help?

Not every episode of renal colic requires a procedure, but there are situations in which waiting is unsafe. A stone obstructing urine flow in the presence of infection is particularly dangerous and may rapidly lead to serious complications.

Urgent medical assessment is required for:

• fever, chills or feeling acutely unwell with flank pain,
• severe pain that cannot be controlled with medication,
• recurrent or persistent vomiting preventing the patient from drinking or taking medication,
• inability to pass urine or a marked reduction in urine output,
• stones in a person with a solitary kidney,
• pregnancy,
• suspected urinary tract infection, pyelonephritis or sepsis,
• marked weakness, fainting, low blood pressure or confusion,
• visible blood in the urine, especially when heavy or recurrent,
• kidney disease, kidney failure or significant coexisting conditions,
• pain in a child, an older person or an immunocompromised patient.

In these situations, the appropriate place may be an emergency department, hospital admissions unit or urgent medical consultation rather than waiting for a routine appointment.

What should you do if renal colic is suspected?

If the pain is mild, the patient feels stable and there is no fever, vomiting, urinary retention or other warning symptom, it is reasonable to contact a doctor and arrange diagnostics. Severe pain or warning symptoms may require urgent help.

Until the consultation, it is worth:

• not driving if the pain is severe, dizziness or vomiting is present, or pain medication has been taken,
• noting when the pain began, where it radiates and whether similar episodes occurred before,
• checking body temperature,
• observing whether blood in the urine, burning, urgency or urinary retention occurs,
• not forcing yourself to drink several litres of water during acute colic,
• not taking random painkillers if you have kidney disease, peptic ulcer disease, take anticoagulants, are pregnant or have other contraindications,
• not taking antibiotics “just in case” without confirmation of infection and a doctor’s decision,
• bringing previous ultrasound, CT, urine test results and hospital discharge summaries to the consultation if stones occurred before.

In severe renal colic, the priorities are pain control, ruling out infection and checking whether urine drainage from the kidney is dangerously obstructed.

How are ureteral stones diagnosed?

Diagnostics depend on the severity of pain, warning symptoms, age, sex, pregnancy, coexisting diseases and whether the patient has had stones before. The doctor begins with the medical history and examination, then selects laboratory and imaging tests.

The following may be needed:

• urinalysis — may show blood, white blood cells, nitrites, crystals or signs of infection,
• urine culture — when symptoms of infection, fever, recurrent infections or planned procedural treatment are present,
• blood tests — creatinine, eGFR, complete blood count, CRP or other parameters when infection or impaired kidney function is suspected,
• urinary tract ultrasound — assessment of the kidneys, dilatation of the collecting system, bladder and sometimes visible stones,
• non-contrast computed tomography — in many situations the most accurate test for detecting a ureteral stone, especially when the diagnosis is uncertain,
• stone composition analysis — if the stone has been passed or removed, this may help prevent recurrence.

Ultrasound is very useful and does not involve radiation, but it does not always show the ureteral stone itself. Sometimes only an indirect sign — kidney obstruction — is visible. CT may therefore be needed when symptoms are severe, the diagnosis is uncertain or treatment is being planned.

Will a ureteral stone pass on its own?

Some ureteral stones pass spontaneously, particularly when they are small and located lower in the ureter. The likelihood depends on several factors: stone size, location, degree of obstruction, pain, the presence of infection and the patient’s general condition.

It is unsafe to assume that every stone will “eventually pass”. A stone may become impacted, cause persistent obstruction, infection, deterioration in kidney function or recurrent pain. Conversely, not every stone requires immediate intervention.

The urologist assesses whether observation is safe or whether medication, urgent intervention, follow-up imaging or a procedure is needed.

Pain treatment in renal colic

Renal colic may be extremely painful, so pain relief is one of the first steps. Guidelines often list non-steroidal anti-inflammatory drugs as first-line treatment when the patient has no contraindications. However, they are not safe for everyone. Contraindications may include kidney disease, peptic ulcer disease, bleeding, some anticoagulants, pregnancy or allergy.

If the pain does not improve, returns in waves, the patient is vomiting or fever develops, treatment at home should not be continued without assessment. Urgent care, intravenous medication, imaging, antibiotics for infection or drainage of the kidney may be necessary.

Do not take medicines prescribed to someone else, combine multiple painkillers or use antibiotics without an indication. In stone disease, antibiotics are needed when infection is present, not for every episode of stone-related pain.

Do you need to drink a lot to push the stone out?

This is a common myth. Good hydration matters for prevention and after the acute episode has resolved, but forcing very large amounts of water during acute colic is not a good method of pushing a stone through. When urine drainage is obstructed, increasing urine production may raise pressure above the blockage and worsen pain.

During acute colic, drink reasonably and avoid dehydration, but do not force yourself to consume very large volumes. Vomiting, fever, inability to pass urine or severe pain require medical help rather than “flushing the stone out” at home.

Medicines that may help a stone pass — when do they make sense?

In selected patients, the doctor may consider medical expulsive therapy, especially for stones in the lower ureter. Medicines that relax ureteral smooth muscle are sometimes used, but they are not appropriate for every patient and do not replace urological follow-up.

This approach requires safe conditions: no fever, no signs of infection, controlled pain, normal or monitored kidney function, access to follow-up and clear instructions about when to seek urgent care. If the stone does not move, pain returns or complications develop, the plan must be changed.

When is a procedure needed?

A procedure is considered when the stone is unlikely to pass safely on its own, causes complications or produces symptoms that are too severe. The most urgent situation is infection with obstructed urine drainage. Rapid decompression of the kidney, for example with a JJ stent or nephrostomy, together with treatment of the infection may then be essential.

Procedural treatment may be needed for:

• fever or infection with urinary obstruction,
• failure to control pain effectively,
• recurrent episodes of renal colic,
• a stone that does not move despite observation,
• a larger stone with a low likelihood of spontaneous passage,
• deterioration in kidney function,
• significant kidney obstruction,
• a solitary kidney or particular risk of loss of kidney function,
• stones in a patient with important occupational or medical reasons for faster treatment.

Treatment methods may include ureteroscopy, laser fragmentation of the stone, temporary placement of a JJ stent, nephrostomy for urgent kidney decompression or other procedures depending on the stone’s location, the patient’s condition and availability of the method.

Stones and infection — why is this combination dangerous?

A stone blocking urine flow may cause infected urine to become trapped in the kidney. This is potentially dangerous. Fever, chills, weakness, low blood pressure, rapid heart rate or confusion together with flank pain require urgent assessment.

Painkillers or oral antibiotics alone may not be sufficient. The urinary system may need to be drained urgently so that urine can flow and the infection can be treated effectively. Fever during renal colic must therefore never be ignored.

What should you do if the stone is passed?

If the patient notices that the stone has passed, it is worth keeping it in a clean container and showing it to the doctor. Analysis of the stone’s composition may help prevent recurrence. Calcium oxalate, uric acid, cystine and infection stones require different preventive approaches.

Relief of pain does not always mean that the problem is completely resolved. Pain may improve when the stone moves lower or when the kidney temporarily produces less urine. In some situations, the doctor may recommend follow-up ultrasound, urinalysis, creatinine or another test to confirm that obstruction has resolved and the kidney is functioning properly.

How can the risk of recurrent stones be reduced?

Stone disease tends to recur, so prevention should be considered after an acute episode. Recommendations depend on the type of stone, test results and the patient’s conditions, but several principles are often shared.

Recurrence prevention may include:

• regular hydration throughout the day so that urine does not remain highly concentrated,
• reducing excessive salt intake,
• avoiding excessive animal protein if recommended by the doctor,
• not restricting dietary calcium without medical advice,
• a sensible approach to foods rich in oxalate in selected patients,
• treatment of urinary tract infections when stones are infection-related,
• monitoring uric acid, urine pH and metabolic disease when indicated,
• analysis of the stone if it has been passed or removed,
• metabolic testing in patients with recurrent, multiple or early-onset stone disease.

A universal “kidney stone diet” should not be used without identifying the type of stone. What helps one patient may be irrelevant or insufficient for another.

Common myths about ureteral stones

• “If it hurts a lot, the stone must be large.” Not always. A small stone in the wrong place may cause severe colic.
• “If the pain has stopped, the stone must have passed.” Not always. Pain may improve temporarily while obstruction persists.
• “You should drink as much water as possible during colic.” No. Drinking very large amounts when urine drainage is obstructed may worsen pain.
• “No blood in the urine means there is no stone.” False. Haematuria is common but may not be visible in every patient.
• “Ultrasound always shows the stone.” False. Ultrasound may not visualise a ureteral stone but may show kidney obstruction.
• “Every stone requires surgery.” False. Some stones can be observed when conditions are safe.
• “Every stone will pass on its own.” False. Some stones require a procedure.
• “Antibiotics help renal colic.” Antibiotics are needed for infection but do not treat the mechanical obstruction itself.
• “Stones affect only men.” False. Stones occur in both women and men, and pregnancy requires particularly careful diagnostics.

Do you have severe flank pain, blood in the urine or a suspected ureteral stone?

Do not assume that every stone will “pass on its own”. A urologist can determine whether ultrasound, urinalysis, pain treatment, observation, CT or urgent intervention is required.

Stone diagnostics at Wyspa Medycyny Przyjaznej in Gdańsk

At Wyspa Medycyny Przyjaznej, patients with flank pain, suspected stones, blood in the urine, symptoms of urinary tract infection or urinary difficulties may begin diagnostics with a urology consultation. Depending on the symptoms, the doctor may consider urinalysis, urine culture, blood tests, urinary tract ultrasound, assessment of kidney obstruction and post-void residual urine, or referral for further imaging.

The purpose of the consultation is not only to confirm a stone. It is to determine whether the symptoms are truly caused by stone disease and whether infection, obstruction, impaired kidney function or another condition requiring urgent help is present.

Learn more about Jakub Gondek, MD Urological ultrasound Urology

What should you ask the urologist about a ureteral stone?

• Do my symptoms really suggest a ureteral stone?
• Is kidney obstruction visible on the examination?
• Do I need ultrasound, CT, urinalysis, urine culture or creatinine testing?
• What is the size and location of the stone?
• Does the stone have a realistic chance of passing on its own?
• Which symptoms mean that I should go to hospital urgently?
• How can I treat the pain safely in view of my conditions and medicines?
• Can I use medicines that may help the stone pass?
• When should follow-up ultrasound or another test be performed?
• Do I need a procedure?
• Should I keep a passed stone for analysis?
• How can I reduce the risk of recurrence?

FAQ — ureteral stones and renal colic

What does pain from a ureteral stone feel like?

It typically causes sudden, severe flank or lower-back pain that may radiate to the groin, testicle, labia, lower abdomen or urethra. The pain often comes in waves and may cause nausea and vomiting.

Does flank pain always mean stones?

No. Similar pain may be caused by kidney infection, appendicitis, gynaecological disease, testicular torsion, bowel disease, spinal pain or other acute conditions. Severe or unusual pain therefore requires diagnostics.

Does blood in the urine mean stones?

It may occur with stones but is not specific to them. Haematuria has many possible causes and requires medical assessment, especially when it is visible, recurrent or unexplained.

Does the absence of blood in the urine exclude a stone?

No. Haematuria is common in stone disease, but its absence does not exclude a ureteral stone. Diagnosis is based on the full picture: symptoms, urinalysis and imaging.

When do stones require urgent help?

Urgent assessment is required for fever, chills, uncontrollable pain, vomiting, inability to pass urine, a solitary kidney, pregnancy, weakness, fainting, suspected infection or deterioration in kidney function.

Will a ureteral stone pass on its own?

Some small stones pass spontaneously, especially when located in the lower ureter. Not every stone has this chance, so its size, location, degree of obstruction and associated symptoms must be assessed.

Should you drink a lot of water during renal colic?

Do not force very large amounts of water during acute colic. When urine drainage is obstructed, this may worsen pain. Hydration is important for preventing recurrence, but acute colic requires a sensible approach.

Will ultrasound detect a ureteral stone?

Ultrasound may detect some stones and assess kidney obstruction, but it does not always show the stone itself. CT may be needed in selected situations.

Does every stone require a procedure?

No. Some stones can be observed if the patient is stable, there is no infection, pain is controlled and the stone is likely to pass. A procedure is considered for complications, a large stone, obstruction, infection or unsuccessful observation.

Who assesses suspected stones at WMP?

At Wyspa Medycyny Przyjaznej, urology consultations are provided by, among others, Jakub Gondek, MD, who diagnoses urinary and reproductive system disorders, urinary problems, pain and symptoms suggesting stones or infection.

Sources for medical and editorial verification

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