Ureteric stone pain: Initial self-management

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Ureteric stone pain is considered as one of the most severe pains in our body can be suffering from. Flank pain wills suddenly happening as a result from the instantly stone occlusion within the ureter. Ureter is a small tube organ with 25 cm long functioning as urine transportation from the kidneys to the urinary bladder. Due to its diameter as small as 4 mm, so it is means that any stone which is sizable are more than just 4 mm, it might be obstructed and expresses the symptom.

The location of the refer pain is valuable in term of roughly ureteric stone localization for example

1. Flank pain which is radiated to the testicle – It might have obstructed at the mid-part of ureter
2. Flank pain which is radiated to the groin area – It might have obstructed at the lower-part of ureter

First thing you need to know is, ureteric stone is one sort of a kidney stone, the kidney stone will float inside the renal pelvis with a randomize direction if it travels through to the ureter and it drops down and becomes a ureteric stone. If you are lucky, the stone will spontaneously pass out with urine without any pain or discomfort, but if not, ureteric stone will cause you a lot of pain. The pain always happens suddenly with the peak at 1 – 2 hours after initial onset.

There are the 3 common site that the ureteric stone more likely to obstruct

• The junction between kidney and ureter
• Mid-part of ureter
• The junction between ureter and bladder – The most ultimate narrowing site

The gold standard for ureteric stone pain is the imaging with a Non-contrasted CT scan that would tell us lots of the information in term of.

1. Location of stone
2. Size of stone
3. Severity of the obstruction – edema of the ureter or affect kidney injury or not?
4. Hardness of stone – for consideration of the treatment options

The question will come up like “Why we don’t use ultrasonography or plain film study?” – They both are good screening investigations tools but not an accurate one being use as s diagnostic tool in case of any procedure needed.

Next, I will show you how to do the initial self-management during ureteric stone pain.

• Anti-inflammatory drug – is the first-line treatment when someone suffering from a ureteric stone pain. With its effect on both pain control and partially reduce pressure in the obstructed ureter. IMPORTANT note, you must free from an allergic to this tablet (anti-inflammatory drug) and no history of renal impairment. But if you are in any contraindication, so the acetaminophen only that would be recommended.
• Take plenty of water – surprisingly that just simply drinking plenty of water can help you reducing the ureteric stone pain. The reason is, the ureteric stone pain’s patients tend to be a dehydrated from vomiting and loss of appetite, the dehydration will consequence with trapped stone in the ureter which prolong the pain. All international guidelines from US and European encourage staying hydration in an active ureteric stone patient.

Self-management on the stone pain is just the initial recommendation and doesn’t get a 100% guarantee that the stone will pass out spontaneously. Once you suffered from this problem, a better way is going immediately to the emergency room for getting a medical urgent. Take care!

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