If you are passing a kidney stone, your chances of successful stone passage are strongly related to stone factors including the size of the stone and its location. Small stones less than 4mm in size have an almost 80% chance of passage while larger stones measuring 8mm or greater have a less than 40% chance of spontaneous passage. Stones that are just starting to move out of the kidney have a 50% chance of passage while stones just about to drop into the bladder have an 80% chance of passage.
Wouldn’t it be great if you could take something to improve your chances of passing your stone? It turns out there are medications your doctor can prescribe for you which may be effective. This treatment is known as “medical expulsive therapy”. The most commonly used medication for this purpose is tamsulosin (Flomax). Other similar medications used to facilitate stone passage include alfuzosin, nifedipine, doxazosin, and terazosin. These medications are known as alpha-blockers and are normally used to relieve prostate obstruction in men (by relaxing smooth muscle in the prostate) or to lower blood pressure in patients with hypertension (by relaxing smooth muscle in blood vessels).
How do they work in stone passage?
The ureter is the hollow structure which transports urine from the kidney to the bladder. It has muscles which contract rhythmically in a process known as peristalsis. These movements normally help to speed the passage of urine down to the bladder. Medications to help pass stones may work by relaxing these ureteral muscles – resulting in a wider and less constricting ureter for stones to more easily pass through.
How well do they work?
In initial studies of patients taking these medications or placebo (sugar pill), those on the medications were 1.45 times more likely to successfully pass their stone. They also required less pain medication and passed their stones more quickly with fewer return trips to the hospital than patients taking placebo. Most early studies however involved small numbers of participants which made their findings less reliable.
Enthusiasm for this treatment approach waned when a large study from the UK published in July of 2015 cast doubt on effectiveness of medical expulsive therapy. The study included 1,167 participants who were given either placebo (sugar pill), tamsulosin, or nifedipine. The participants were then followed to see whether they passed their stone successfully. After 4 weeks, there were no differences seen, with 80% of those receiving placebo not needing further treatment, compared to 81% of those receiving tamsulosin and 80% of those receiving nifedipine. Pain scores, pain medication use, and time to stone passage also did not differ between the groups. Was this the end of medical expulsive therapy? Not quite – in medicine, more than one study is often needed to get a reliable answer and the question of whether medical expulsive therapy awaited additional research.
A subsequent analysis published by the Cochrane Library in 2018 pooled the findings from 15 studies with a combined total of 5,787 participants to try to get at a more definitive answer. In contrast to the UK study above, their combined results suggested kidney stone patients who took an alpha blocker medications were slightly more likely to pass their stones at a calculated relative risk of 1.16 (for each 1,000 patients who took an alpha blocker, 116 more passed their stones compared to those who took placebo (a sugar pill). Those who took an alpha blocker also seemed to more quickly pass their stones (3.4 days faster), have fewer hospitalizations (69 fewer hospitalizations per 1,000 patients), and take less pain medication. The effect of these medications seemed to be stronger for stones larger than 5mm. The downside of these medications was a slight increase in side effects (29 adverse events per 1,000 patients). These side effects included low blood pressure, fainting, racing heartbeat, and irregular heart beats.
The takeaway on medical expulsive therapy
The bottom line appears to be that medications used for medical expulsive therapy may modestly improve your chances of passing your stone and how quickly you pass your stone. They may also reduce the need for pain medications or hospitalization. They however may cause side effects in a small number of patients. The decision on whether to use these medications should ultimately be made with your medical provider and should take into account your chances of passing your stone spontaneously and whether you are at increased risk for serious consequences from any potential side effects.
Suffering frm 10 mm ..stone in my my ri8 side kidney…
I always feel lyk vomitinG.. I cant digest my food properly.. my body fully paining ..
well i have went 16 years now dealing with stones …i have a large stone in my right kidney now ..an if you go the hospital they check an find the stone send you home with that strainer thing to piss in….what good does that do when someone has pain an can not pee ..i hate the medical system in the u.s all about the all mighty dollar..or you go to a doctor an ask for a appointment an you get we can not get you in how about next week..or if you go to a walk in clinic amelia island health care an they leave you in the waiting room for three hours throw you in a room an forget you are their… americas medical care is shit if you are rich you are great shape the poor just die
i was diagonised and found out that i have 13mm kidney stone and i am living in Sierra Leone.what can i do?this is a country with no expert on kidney.how can u help me
I have a 11.3 mm stone stuck at the end of the ureter tube and its causing a lot
of back pressure and pain in the back. At times the urine flow is fine but at times
obstructed and pain and burning sensation is unimaginable. Since I have had
bariatic surgery I think the Lithotripsy is a risky procedure as it might injure and
open up the staples in my abdomen. Any advise would be appreciated.
Thanks – Sam
I devoloped cronic stones a couple years after my Roux-en y procedure. Most pass on their own and are a few centimeters. I have had lithrotripsy done for some large ones and have had no issues with it causing issues with my pouch. I have also had surgical intervention as well as a stent. Just today, after a month of suffering I passed an 8mm stone, all on my own. I guess what I am saying is don’t worry about the gastric bypass site, the lithrotripsy will give you almost immediate relief.
I’m a forty-six year old disabled veteran and I can relate with you all regarding kidney stones the rocks from hell…I have had three and I’m currently working on my forth one now. All of them have been between 7 and 8mm,which are usually too big to pass on their own through the tiny ureters. Although my current one is 8mm, but amazingly has managed to make its way to the top of the bladder, but refuses to make that final nudge into my bladder. I’ve undergone lithotripsy on my first stone and even though they gave me Fentenyl IV that stone being smashed with sound waves and bouncing against the ureter wall was excruciating to say the least and unfortunately with this process there’s usually enough fragments left behind to form a sister stone. The last two were blasted by a laser under general anesthesia and I didn’t have to endure any memory or pain during the procedure. The only problem with either procedure is that stents have to be inserted to keep the plumbing open from all the swelling that will occur after either process. All of my stones have been the Uric Acid kind. The only non-preventive processes are to refrain from drinking tea; reduce sodium intake; no dark green leafy veggies; and no protein containing purines. I even bought a water filter to install on my kitchen sink to help remove unwanted chemicals and minerals. I was also told genetics play a big role here as well. Stay hydrated as much as possible and drink a glass of warm water containing one TBSP of baki g soda to deacidify my blood at least once a month. Dilaudid IV for pain along with maybe Toridol or some other anti-inflammatory medication via IV fluids to keep hydrated until you pass it or have a surgical intervention to remove it. It would be great to have a standing order for pain meds, but anything they can prescribe for you to take at home usually doesn’t touch the pain.
I am scared to death. I had to go to er and catscan found a 5 mm kidney stone. I am home alone watching grandson at night. I’m scared if I pass this I will pass out from pain? I can’t think of anything. I’ve been vomiting and at times can’t stand straight up. I the pain is going down into my leg too. Should I call someone to have on standby or am I gonna make it alone?
I’m afraid to take climax, because of the side effects, but sounds like it helps to pass the stone. I have a 3,3 cm? Or mm. Dr said it was small. I have a 6 ,year old have to take to school and back. Should I take the climax? First timer with a stone. Any advice will help!
I’m not sure if all of you have researched much but, the very latest studies in the US show you can reduce the incidence of calcium oxalate (CO) stones by 90% by taking 300-500 mg per day of magnesium oxide or mag. citrate, or a potassium/magnesium citrate combination available almost everywhere. You can further reduce stone production by adding 40-100mg of B6 (pyridoxine) daily. As well, IP-6 (inositol hexaphosphate) has been studied for over 50 years and known to help stone reduction. Citrate (lemon juice, etc.) will not dissolve stones, but it will increase the acidity of the urine helping stabilize the crystal formation rate. Also, apple cider vinegar will in no way help soften or dissolve stones. Folk lore only.
Now the part your not going to like. There is nothing that can dissolve CO stones after formation. Not one empirical study has validated any of the claims made by ‘formulations’ companies claiming stone dissolution using their products. The much hyped Peruvian herb ‘Piedra Chanca – stone breaker’, included in almost all of these formulations, is total marketing mythology. When asked to provide the peer reviewed studies verifying their claims, none have produced that can be substantiated.
Here is what you must do without fail. Diet has been shown to be the No.1 most effective way of reducing CO stones. There is significant evidence that moving to a low oxalate diet is utterly crucial to minimize stones. Go here as a start –
https://mydoctor.kaiserpermanente.org/ncal/Images/Dietary%20Changes%20to%20Prevent%20Calcium%20Oxalate%20Stones_tcm75-194243.pdf
There is no option but to be as strict as individually possible to eat a low oxalate diet the rest of your life. You truly do not have a choice if you are going to minimize screaming your lungs out ,throwing up, almost destroying a kidney and dying as I did for 50 straight hours through this past X-mas Eve. Once you review this list you will see why I said you won’t like it. No chocolate, sugar, etc. But, eat right or scream, your choice.
One last thing you should know about the calcium myth, it doesn’t make stones, you absolutely must have it in your diet. Every single time you have an oxalate meal you must include a little bit of dairy (milk, cheese, yogurt, ice cream, etc) for a calcium source, that has now been shown, over the last 10 years, to BIND with the oxalate in your intestine PRIOR to getting to your kidneys and growing a stone. The oxalate/calcium molecule is then excreted in the urine.
Well, a lot more could be said but this should bet you started. I hope this helps somebody. Good luck.
Great information, Ed. Thank you for sharing.
I wish I could leave some encouraging comment for those suffering with stones. I recently had my second cystoscope surgery, the experience is a nightmare. The stent is maybe the worst part.
I have suffered from kidney stones for the past 24 years and all associated pain that goes with it. I have either passed them myself,lithotripsey or surgery. The many stents that have been put in pace has now left me with a weak bladder and at the moment, i have a 1.10mm stone that has been stuck in my uretha for the past eight weeks and is not budging. If i never saw water again the rest of my life, i would be very happy. At times, to help myself i am so full of water, that i am no longer hungry.
To all kidney stone sufferers, my heart goes out to you. The pain is horrific and no cure has been found as yet to dissolve them or stop them forming. My advice, go to you doctor and if possible ask for lithotrisey which breaks them down. My only concern is, this treatment alone can cause a blood clot. An operation to remove the stones also has possible side effects but, at a time where the pain starts and is continuous, it doesn’t matter. I get to the point whereon my hands and knees, i could beg some one to remove the stone to stop the pain and at any costs.
I really sympathize with you because I have suffered more than enough from kidney stone. One day a friend of mine was driving me to the hospital in his car. We were approaching the hospital when the traffic went green and I felt I would die if it went red before we pass. I have always wondered how can a weak human body keep up with such a huge pain. Recently I passed three small stones but one fourth got stuck in the urethra and won’t move. The problem with this one is not passing urine but rather controlling it when you are out in the street.
I understand exactly what you are going through. I have been trying to pass a 5mm stone since Dec 5,2015. The first month it did not move at all, was stuck midway between my kidney and bladder. A friend of mine told me to try Renavive The natural kidney cleanse Supplement because they said it would actually break the stone down enough to allow it to move. I was a little skeptical but I started taking it and on my third week of taking it I felt it move went back for x-ray and it was right next to my bladder. But now it’s been right at my bladder for two weeks and won’t go into my bladder. I feel the same way about what her now, I love drinking water but now I’ve been drinking so much that it actually makes me even more nauseous and full feeling when I have to keep drinking it, but don’t have a choice. I’m going to keep taking the supplement and and pray that I pass it soon. I do not wish this pain on anyone. I wish you luck and I hope you can pass your soon! Best wishes
Hey all you people please help!
I am recommended from selection board for leutinent post in army and had my medicals as a part of selection procedure.I have been diagnosed with one 5mm stone in right kidney and 3 stones in left kidney biggest of which is 10 mm.
I want to ask all you people what is the best possible treatment I can undergo
I have only been allotted 30 days to resolve this issue.please guide me.
I am having a 16mm stones stuck in the left urethra and a 5.1mm in the left kidney.
I did a ESWL and it didn’t break the stone in the urethra well due to the stone very hard. Only about 15-20% of the stone is out.
After 3 months, I had another round of ESWL. And finally the stone has broken up.
For you case, 5mm is not a problem. Your focus should be the 10mm. ESWL is strongly recommended. After the treatment, you just need 2 days rest and you can be back to work.
My current experience FYI First time stone. Pain develops and becomes excruciating and literally was/ is unbearable. Worse than labor. Pain Wraps around side like a C. But caused back muscles and stomach muscles to give out almost. Nausea. Called nurse line, and others who know, they all said go to E.R. not urgent care. So I barely made it to ER. They give IV of “I requested Delaudid” sp? vs. morphine. IT works well. Also, They said to take “IBUPROPHIN” every 4 hours. This should help. It kicks in 20-45 mins. As alternative to stronger pain killer they give. Pain is constant, and pain killers wear off every 4 hours, so.. This was my experience.. so far…They gave me flomax too, which I don’t want to take, to relax the urethra and bladder. To Pass it, google natural remedies too. Pineapple, magnesium potassium citrate form. Lemon juice in water, etc. Note: first signs before the side pain I had blood in urine tests, and pain in lower abdomen with negative test on any infection or bacteria. Then the side came esp. after drinking alcohol, coffee, and fast food. (worsened to the E.R. visit next day)
Dear Sir,
I have 4cm stones in left kidney,so pls give me best way to fully treatment of removed stones..
Thx
Badar PKS
You need to know the type of stone. If it is Calcium oxalate, you can alkalize the urine with citrus (juice of two or three lemons a day). I also take the citrate forms of potassium, magnesium, and calcium. Yes, I said calcium. It is especially important to take calcium when drinking beer or eating veggies like spinach that have tons of oxalate in them. The calcium supplement you take binds with the oxalate in your food and does not let it get absorbed.
Also, buy yourself some pH strips to see if you are successfully alkalizing your urine. Look up the oxalate content of the foods you eat.
If your stone is uric acid, I’m not sure how that might be dissolved but extra water for any stone is always recommended. If you are a uric acid former, stay away from sardines and other high purine foods, and stay away from sugar and anything containing fructose.
One final word, no bastard urologist has EVER told me about the value of calcium or about alkalizing the urine. Of course not; they want to make money fucking you over with a stent on the pretense that the “gravel” (after lithotripsy) will clog up your ureters and cause greater problems–fucking hogwash. Where’s the government when you need them. Oh yea, engaging in insider trading (fuckers in BOTH parties).
Was that really necessary? Your point came across beautifully until all the cursing. Then turned very offensive. Please be respectful and keep it clean for others. Thank you and thanks for the good info. I know it will help others including myself who just starting having kidney stones for the first time 2 1/2 weeks go and go tomorrow for a ct scan for conformation. I am anxious to see what it shows. The pain is so much more severe now than then. I drank equal parts of lemon juice, extra virgin olive oil, and apple cidar vinegar and the next morning I started passing stones that looked like sand and coffee *grounds.(several grains each in color)
Cursing is good for the soul. Fuck You Brenda. See, I feel better already.
Over the past year, I have had several problems due to calcium oxalate kidney stones and multiple surgeries, and believe another one is stuck. How much of the concoction did you need to drink to have the result you had? Does it work on calcium oxalate stones?
For such a stone I think surgery is the only solution.
Summary…
16 mm kidney stone stuck in the left kidney, doctor said imagine a funnel, the kidney is the top part of the kidney, the stone is stuck at the top of the tube.
I have had agony for 2 years.
I was told 2 years ago i had 5 kidney stones stuck in the tubes, on Thursday last week i was told i have this big huge stone that is stuck.
I have tried the herbs tea, the tincture, the lemon juice, you name it, i have also tried having coconut oil and also oregano oil.. nothing is moving this stone.
Blood in the urine, well yeah i would think that was a possibility seeing the size of the thing.
I was thinking of asking my doctor for “Water tablets” do you think this might work?
I have been taking Buscopan.
I am abit too scared of having the shock wave treatment, i have heard it can cause cancer in later life, something i am don’t need to put myself through..
If your stone is that large and persistent then my guess is they would do laser lithrotripsy over ESWL (shockwave). I have had both and the shockwave didn’t break up my stones enough. The laser lithrotripsy did break up whatever current stone was causing trouble and broke others into smaller pieces. “Water tablets” could make you dehydrated which is pretty much universally bad for people who make kidney stones. The drugs they mention above, like FloMax, help open up the urinary tract.
The USG and CT Scan show an 8.2 mm stone in ureter and my doctor says it is blocking flow of urine in the right kidney (hydronephrology). But I feel very little or no pain. Doctor has advised immediate lithotripsy. Should I go for it?
Hi there,
I went to the ER by myself three weeks ago knowing fully well based on the symptoms that kidney stone is here again.I was diagnosed with a 5mm stone and the Dr.was hopeful that i will pass it.I visited my Urologist a few day after leaving the ER (spent 3hrs),the same Urologist that performed the Shockwave litho surgery about a year ago and he confirmed that the stone had moved but not yet in my bladder ,positive sign. However it’s been 4 weeks,i strongly believe the sotne is still there but i dont feel any pain.My concern is that i hope this will not damage my kidney.I’m still on Flowmax and drinking gallons of water everyday.
Any advise on how to pass this sotne and the implications of it still there.The Urologist did not advise or preventive measures despite the huge cost of last year’s surgery and the various test that had been done.
Please advise, i don’t want any surgery or want to go throug the discomfort of stent insertion again, huh that was painful during the last surgery.
Thanks,
KO
My wife suffering for 5 mm between kidney & urine pipe stones. How to remove this problem ? Plz. Tell me some idea
i have one13mm stone in pelvis of right kidney
hello..i wonder if you could help me..my father has kidney stones but it’s in his bladder already..may i ask, is the treatment/medication for this the same or it’s a special case..we believe that the stone is about 3cm..
It is simply impossible for a 3cm stone to pass from the kidney to the bladder. Perhaps you meant 3mm? Any stone that can naturally pass from the kidney to the bladder will have no trouble being urinated out of the bladder.
I am discharge today from hospital,3days ago i felt pain as if am in labor,i was admitted in hosp,after ultrasound found that i have 3 left kidney stones.13mm midsection,5mm&6mm inferior.do i have a chance to pass it out? Surgery really needed? Is there medicines that can dissolve or lessen the size?am so scared
no way to pass kidney stone its above 5mm stone is difficult to pass.try alfusin, stone slove,tablet.
In my experience, ultrasound doesn’t always accurately give the size of the stone. A big stone could actually be a cluster of smaller stones.
Is there anyway I can pass my kidney stone. It is 8mm and my insurance hasn’t came threw yet the pain is above a 10 I can’t walk anymore it hurts so bad
I have been diagnosed 8.2 distal ureteric colic can it be removed by medicine
I have been diagnosed with a uric acid kidney stone in my left side. Went into hospital this past August. I was given a stent and some medications to try and break it up. So far it has been in there 5 months because I do not have health insurance currently. I went again to hospital and my urologist was not available for an appointment until today. I have been having severe pains in my abdomen and feeling pressure in my bladder when I stand up and sometimes itching and extremely painful urination like glass is cutting into me. I found this website out of desperation because I tried to get hospital care this past Wednesday and they were not able to reach my regular doctor.
They were not able to get any IV s in me but one for about 5 minutes or so to extract enough blood to get basic results. But I was not able to keep it in. A Cat scan showed some fluid around my kidney ands something called calcification. Still trying to figure out what that means. Help.
When I passed my first stone, I gave it to Dr. To be tested. He told me mine were calcium. To stay away from TUMS, limit all calcium intake, butter, milk, etc.
I had 2 more in kidneys. Trying to pass one now.
It will hurt like all get out. It feels like you said, urinating shards of glass.
Talk to your doctors about what the signs you need to go to hospital immediately.
Hope this helps. Samantha
Hi. Calcification is basically stone formation
Hi, this is not an answer for you but a q to you . About 4 days back I have been diagnosed with a 4.2 mm stone in my left renal. The doctor is quite confident that it will pass naturally in a couple of Weeks and that I do not need any surgery. However he has told my family to not let me travel at all for this period. I am in a sales job and need to do day trips at the least to still remain employed 🙂 My q is is he correct to as me not to Travel ? Also how have you been managing for the last year ?
I started having severe pain and bleeding on Christmas Day. Then pain and bleeding on and off for 6 months; sometimes I went 3 weeks without problems. I had a CT scan in June which found a 5mm stone in the outlet to my left kidney. I passed the stone at the end of July after taking Tamsulosin. Over those 7 months, I travelled for work (probably no more than 4 hours away from where I live though and mainly by train) and sometimes stayed away overnight. My main concern was passing the stone or having complications while I was away from home. My ‘insurance’ was always to pack plenty of prescription meds (anti-inflamatories and strong pain killers). I guess your doctor was just being cautious; if you had a problem while you were on the road you might end up in hospital a long way from where you live. Also not a good idea to drive if you’re in a lot of pain or on strong meds. You need to weigh up the pros and cons of taking his advice.
Travel by car, OK I know from experience, between the vibration and bumps make the stones move. When they move you can bleed a lot, and can cause extreme pain. Also know once you pass one you are prone to pass more.
I have a 10.5 mm stone in my left renal. I have been taking medicines for last 3 year but couldn’t get any good results. shall i go for laser surgery ?
I think that you should have your stone removed, definitely with laser surgery cause a 10.5 mm stone is too big too pass. i have had 4 or 5 attacks throughout the years. When i was 32, 6 weeks after my youngest daughter was born, I had an attack back then. This was 1991. I had no idea what it was. I woke up that morning. My bladder kind of ached and felt like I had to pee but it didn’t hurt too much till later in the day. Then it was excruciating pain that I couldn’t bear. It was on the right side. The first thing I thought was is it my appendix. When my ex husband took me to the hospital back then, they checked my appendix first. Ruled out that it wasn’t. They ran more tests, blood work, urine samples. Then said it was a kidney stone. They said that I passed hit then. Was sent home later that day but had to do 3 days urine cultures and then take them to the hospital. A year or so later I started getting more. I knew what they were then. I had 3 more. The third one, they had to remove cause it wouldn’t pass on it’s own. I was in the hospital about 3 days then before they removed it. They were hoping it would pass on it’s own but didn’t. Now I am 55 and have been diagnosed with having a 3mm one on my upper pole right kidney and a smaller 1 mm one one my left kidney. I am scared for both of them to pass. Also my oldest daughter who is 35 has also inherited them from me. I feel so bad for her. She had them the same age when I started to get them. She has been in the hospital for hers too in the past. Please think about getting yours removed cause a 10.5 one is too big to pass on it’s own.
I am a “Chronic” kidney stone producer, started in “1978” and the 1 stone had to be cut from the belly bottom down to remove that stone (ancient history now a days!!) and have had 15 surgeries last one recently as of the date 10/28/14, had 5 in the right side 3 were the big ones described below. I have passed some, but mostly they have gotten so big, I have had to have them surgically removed. I had the laser, the “wave” and the tubal placement in the back to the kidney. I have had more than my share of 10X10X13 and 10X10X12, and 10X10X10 stones that had to be surgically removed, a stent is placed in the ureter tube to keep the flow of urine coming out after surgery, and for men it is a definite for that. My 37 year old son has only had 2 surgeries and passed over 100 stones, he refuses to have surgery unless it is so bad that he feels like DYING!.He started at age 27….The urologist is the only one who should determine if it is too big to pass, as I have passed quite a few big ones to me 4mm and less, by myself, but to me anything over 4mm is a reason to have it removed. They can block the flow of urine and cause kidney failure if not taken care of in some cases. My 5 were doing just this, blocking the flow of urine in the right side. I just had a surgery in June of this year for a stone blocking the flow of urine on the same side, so I am a chronic producer.The MOST important thing is to drink drink drink lots of water especially when you are having an attack, that helps to push it out if you are able. I have tried all the “remedies” to stop production (ha ha) nothing has helped. I have other issues like HBP and HC, diabetes, and I also take a water pill to help with the flow of urine which depletes the potassium levels, so I have to take 8 potassium pills a day. I have forbid myself to go to the emergency room anymore when I have an attack, I have learned to medicate myself at home. The ER just dopes you up, sends you home, and tells you to call the doctor anyway (I saved numerous ER charges this way). I have a standing order to get filled of percocet from my doctor if I need them, for just this reason. As far as a cure or medication to dissolve the stone, this website has actually said, that their is no medicine to dissolve these painful stones. I feel for you and your pain, but YES have it removed!
use alfusin or stone solve,and thumsolusin
U shud try the shock wave treatment