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.
I have had 4 stones in my life, The first one was just over 1 cm (Approximately 1/4 inch) and I passed them all naturally. I went to the emergency room every time. I always asked for them to increase the amount of saline solution they gave me and passed them all in less than twelve hours of having the IV’s. They all hurt like hell but no “NATURAL” cures ever helped and I tried them all. Fact is there is only hypothesis and speculation as to what causes them. They blamed mine on Autism.
Has anyone ever had multiple tiny 0.5-1mm stones in a “log jam” in the ureter? I looked up my CT scan and it said it was covering an area of over 3mm! What the heck! Will this pass? The Dr. in the ER didn’t sound very positive. Not much pain so far thought I had a bladder infection.
Thanks for any advise experience with this.
Holly
I had the same problem for multiple times as I my body has tendency to form Stones regularly. Do not worry, increase fluid intake and be watchful about any kind of urinal infection (any burning sensation while urination or cloudy/unclear urine). In my personal experience, I also observed that heavy physical activities ( like running, swimming etc.) helps to push the stones further towards bladder.
My husband has had back to back uti’s for a year. He is morbidly obese so the cat scans cannot see well enough to pin point a stones diagnosis. During infections his pain raises to 5-10 and higher. Without infection his pain stays 1-3. Now they say also has prostatitis. We’re getting no direction, even from urologist. We don’t know what to do. Can anyone make suggestions?
Loose the weight! I have stones for more then 15 years…. Loosing the weight is the best way to pass stones..albeit with medication. Even if it is temporary loss induced by the laxatives. The guts, when full (also the visceral fat) squeeze the urethers to the point, the stone just cannot pass freely, not even with use of professional muscle relaxers……it is like if you step on the garden hose and trying to run through it a water with sand……water might get through slowly, but the sand will have hi difficulty….
Stones do not have to be sharp to hurt…just the fact that they touch on inside of squeezed ureter is crazy painful.
There are many procedures, which remove stubborn stones….braking it with sound shock or laser or endoscopic operation, when they insert tiny ‘snake like’ instrument through the penis into the ureter or even kidney.The instrument has a little claws at the end used to catch and pull out the stone. The least desired then is a operation, when they cut the kidney open and remove stones directly….
This should have been offered to you by your “urologist”…Of course, with no insurance it can be very expensive.
been told i have 10mm kidney stone have to see specialist .1st time for me. but i have no pain shall i just leave it to pass ?
That is a big stone and you probably won’t be able to pass it without help. I have been passing stones for 30 years. Smaller ones can pass but larger stones usually require lithotripsy to break up the stone.
Like Debbie, I’ve been passing stones for 30+ years. I’ve passed so many that I stopped counting after 26. Out of the stones I’ve passed only 2 required hospital admission. Attempts to retrieve the stones were not successful either time. Stents were left in for 10 days, but the stones took over a month to appear. Your stone size would be consider too big to pass. Normally those under 5mm can pass but that’s not always the case either. Good Luck.
Sound shock machine or laser brakes them up….
My stent was left in me whole month…next stone passed much easier….
My husband had an 11mm stone in his right kidney. The doctor he saw in the ER said they usually don’t let you try to pass one bigger than 5mm. He just had laser lithotripsy done yesterday to blast the stone into smaller pieces. Since your post is from January, I hope you’ve had it taken care of already. The longer it stays in your kidney bouncing around, the more damage it does.
I have 7mm stone midway between kidney and bladder – right side. This is my third time, five year intervals, that I had KS. I passed stones in the first two episodes – I don’t recal the size. I do remember the pain! I have BPH – large prostate (138). I am looking for a natural remedy dissolver to reduce size of the 7mm stone. I take 1 x 0.4 mg Flowmax daily. Thank you for any suggestions.
Flomax and plenty of fluids is the only thing I have used when trying to pass stones. I have passed stones for 30 years. Not a pleasant experience.
I have MSK and pass gravel daily and bigger stones a lot. I’m on a low Oxalate diet due to the kind of stones I pass. Beer helps, fresh lemonade not cranberry juice; I mean cranberry juice is good for your kidneys but don’t help with stones, Olive oil helps them pass. It would help you if you took something to dialte you.
Cola de Caballo or Chunkapiedra (herb mix from south America)….are the natural ways, but it works rather slow and best used as prevention.
In old time people used tea from poppy heads….just cook it for 5-10 minutes. But it is dangerous, as if you do not understand dosing you can die for overdose of opium….
I ve got a stone 5.5mm… jad it for 3 months 4 trips to the hospital so far. It should be in my bladder. Good I love Morphine.. Anyway of to the urologist on Tuesday.
Chanca pedra use it you will feel better
I am on my 3rd bout of stones in the last 18 years. The last episode, I had ureteroscopy with stents placed. that was awful! Now I have been told that I have stones in both kidneys and there is one in the left kidney that is 2.7 cm. I was told by the urologist the only way to get rid of this is through percutaneous nephrolithotomy. This seems extreme , not to mention painful. I am very concerned about my kidney being punctured with a nephrostomy tube. Has anyone else had experience with this procedure or with stones this size?
I am on my 11th stone in 8.5 years. Any time I get them in my left kidney I have to have them removed by surgery. I’ve had a stint 2 different times. First time they removed the stone and placed the stint. Second time they did not remove the stone but placed the stint then 2.5 months later I finally got them to remove both. Stones on my left side have ranged from 5.5 to 7.8 mm. Any time I have a stone on my right side I am able to pass them on my own. I was told I have calcium leaking into my kidneys and they is what is forming the stones. Nothing that can be done about or at least that’s what they’ve told me. I haven’t ever hears of the percutaneous nephrolithotomy procedure but it sounds scary to me.
Anna, what you are talking about is totally different then having the nepheostomy placed. It’s a large tube that comes out of your kidney through your back and drains urine in a bag. I had this in 2015 and hope to never have it again. However, it is the only way to get rid of certain sized stones in certain areas of the kidney. I would get a second opinion before I did it again though. Pretty serious and rough. Recovering from blasting now though and it’s not much fun either.
Hi, I have almost 3CM on my left kidney I have done Lithotripsy done in Dec -2017 and passed my stone in a two weeks 2 nd session done last week on Jan -24th still waiting to be passed but too much pain in a bladder right now but Ketorolac 10 MG will help to relief pain
good luck
Have a tiny one stuck in urethra hospitalized 3 times since wed pain intolerable
I also hv 5mm in lower ureter n it had killing pain, now I’m under homeopathy treatment.
Hope it gets out at d earliest.
Homeopathy is a pseudoscience. Water does not have memory as believed by homeopaths. It was invented in the 1700’s when anything was believed to help since at that time medicine was in it’s infancy stages. Just search “is homeopathy pseudoscience” When you search anything in the form of a question you get non-biased results.
i have 1.1cm stone in my right kidney please help
I have a 1.2 cm stone in right kidney I had 4 sessions of lipotropsy & I have a stent…some days pain free, other days not so good like today. I am waiting to see my urologist in 2 weeks. I feel if stent was gone, ixe be ok, v painful to day the least…trying lemon juice & Olive oil today..best wishes to you.
I went through this 3 years ago so my heart goes out to you. I was told that I had a stone the size of a gum ball. It was huge but the doctor decided to go the Lipitrsy route. I had at least 5-6 rounds of that as they tried to break it up with shock treatments. This didn’t work so after being put through the many attempts they stuck a stent in me. That didn’t work. Not to mention that it was painful. Long story but they eventually had to go retrieve it with surgery. A basket and this was after months of pain, trying everything but the one option that was clearly necessary. My answer to your question is most likely not going to be able to pass it without surgery. Go see your doctor informed. My best wishes for a good outcome.
I had a stent in for 6 weeks. Never passed anything. Complete torture. Never again.
Learn about treatment for kidney stones, including waiting for the stone to pass, taking pain medicine, or having a procedure to remove the stone.
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I wish I had found this site 10 + years ago. If kidney stones were worth as much as diamonds, I would be rich. The first stone was the absolute worst – until now. For several years I passed stones routinely without much more than some pain meds, and then very little. I do not like the way my mind is muddled when I take pain meds. A few months ago I had a CT done because of prostate problems. The Dr spotted a 8+ mm stone deep in my left kidney. Mind you, the prostate pain was already tough to take and the Dr guesstimated it would be 6 or more months before there would maybe need to be some kind of treatment for this stone. It turns out it moved from deep in the kidney to being problematic within two months. Now I am in week 10 of pain and discomfort. Every time I wake up pain free, the euphoria lasts just a couple of hours before that horse kicks again. The only good thing I have learned from this concurrent prostate and kidney stone episode is that if your man parts hurt, it is very unlikely to be prostate cancer. Apparently, there is no pain with prostate cancer. Prostatitis hurts ALL under. As for comparing the pain from the two, kidney stones hurt MUCH worse. Prostatitis made me quite a bit more ill feeling; I suspect the infection had a lot to do with that. Oh, yeah, if it only hurts when you pee, it is not a kidney stone. Those little suckers hurt from kidney to bladder and again from bladder to toilet. Someone needs to invent a kidney stone vibrating mat that uses ultrasonic waves to help move those things along faster. They can call it Shake-n-Pee or Vibe-n-Pee.
I found your comment humorous. I’m going through yet my second bout with a stone approximately the same size as yours. It sure would be convenient to have the shock treatment at home as all the trips to the Stone institute was getting old and just didn’t work for me. There are risk to the lipitripy route as well. You can google it. I’m convinced the urologist get a kick back from in my case the Stone institute. My stone at that time was the size of a gum ball as they joked about among themselves. I wasn’t laughing. Months of this and I had to have a “ basket procedure “ to retrieve it. Whose wise decision was it to begin to think that it would pass is anybody’s guess but ask questions. I didn’t and I wish I had known now what I didn’t know then. Be proactive about your health care because many doctors are not going to tell you that they just might be in their best interest to have you go with the shock treatments. I’m convinced that my neurologist got a kickback from all those shock treatments and at my suffering.
I am awaiting my lab results to see if I have kidney stones. If I do I am more fortunate then most because my only symptom is my side hurts like a real mother $&@#% pardon my potty mouth. I live in Kuwait so your results can take 2 days to two weeks and I wasn’t in much pain the day I went in. Now Ione day later I can barely stand and may soon need to crawl to get around. Your idea for about the vibrating mat is right on the $money$ honey. Now to go and drink a ton of water and wait for my test result to tell me that I am going to give birth to a kidney stone soon. Note to self get lots of pain medication and reward self with new dress and expensive perfume after giving birth to little satan (yes I name my pain..doesn’t everyone ^_^)
A large 20mm stone was silent in my kidney for who knows how long and was discovered by accident by CT scan because of acute pain from a small stone in the other kidney that I passed. Underwent ESWL for the large stone which accomplished nothing except me peeing blood and probably sustaining kidney damage. Then 2 successive laser lithotripsy adventures that provided partial relief but left seed fragments in my kidney. Now, 7 years later, one of the seeds has grown to 10mm and a laser lithotripsy dusting only slightly reduced it. MD says he has to stop dusting because he cannot see and thus cannot continue to remove stone. I researched equipment and discovered state-of-the-art laser units have superior irrigation to rinse away dust during a procedure and have enhanced imaging. But I doubt hospitals or doctors will admit they use less than the best. In pain and frustrated and probably sustaining kidney induced body damage.
Please help me!!! I have a 2mm stone diagnosed 6 months ago in thailand.Doctor said no meds for it just operation 2000 $ cutting me open.as i am still in thailand i cant afford it.I’v been drinking lemon and olive oil nearly everyday but it seems to help,,at least for an hour!!i dont have health insurance and no possibilty of going uk till next year.I can feel it.is there anything else i can do?am i leaving it too long?im in great shape,, 50, dont smoke or drink!!! Please please help me?
try Chanca Piedra it is known to be a “stone crusher”
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Watch the movie “What the Health” on Netflix. I have Kidney Stones too. Plant based diet is what I’m now doing. To much meat and dairy protein is what causes them. Just passed my first one, C-scan on Monday. I’m so done, I’ll change my whole way of living to conquer these miserable invaders. Good luck
Not true. Meat and dairy don’t help but they aren’t the worst thing. It’s oxalate. Dark green vegetables, rhubarb, bran, nuts and chocolate are the main culprits. And spinach is by far and away the worse – up to 10x as bad as any other food item. Stay away from those foods as much as possible. The problem of course is if you list all foods they tell you to avoid you’d live on apples and air. http://kidneystones.uchicago.edu/how-to-eat-a-low-oxalate-diet/
You don’t need anything for a 2mm stone – it’s small enough it will pass on its own. Just drink a lot of water and see if you can get a prescription for Flomax.
Was told I’m passing a 2mm and 3mm from my left kidney yesterday. I’ve been passing blood for about a week now and decided to go in when my daughter started crying because she was worried about me. They put me on alfuzosin. Today it feels like a sharp tortilla chip going down my throat but it’s in my lower abdominal area, in the dead center. I have a big interview at work tomorrow that I’m not missing regardless of how much pain I’m in. But I’m hurting bad enough today that I stayed home. I am also trying the stone breaker supplement to help aid the process. I’ve broken my back twice, my neck once and shattered my right foot and this type of pain is worse than the pain I had with those.
Hi this is naveen from India …I’m also get stones don’t worry about during water 6liter perday …avoid fast food …mostly cabbage , beans.nuts..fishincluding egg.. and eat orange ..carrot ..corns.. first u during water regular..this is the medicine …and walk half an hour …daily twice….bananas bottam which means have to make like soups …have a great day if u read just msg me I give tips don’t worry
To all who are allowing MDs to add scars your tubes with physical intervention: Once should be enough to realize that they are only making the tube smaller with the scar tissue they cause. If you haven’t heard of Royal Break-stone (Chanca Piedra) sold thru Whole World Botanicals. Available online. Try it! It passes a stone in 1 to 3 hours. I have doctors trying to cure me with antibiotics. They don’t help to pass stones.Try the herb! 2caps daily with large glass of distilled water, while managing a stone., and you are enjoying a meal before the day is out. Never seen anything like it in all my years of struggling with kidney stones. Then look up your blood type and discover what and how you are eating that is not digesting properly. You will find the answer to why they start in the first place. God Bless you all! Its a tough disease.
I am so glad to read this. I have an 7mm stone stuck in my ureter and I do not want to have lithotripsy based on my intuition telling me to avoid it. I ordered the “Stonebreaker” and am taking Chinese herbs to hopefully cure it.
Hi, I’m curious if you would tell me why your urologist advises you against the shock treatments. Did they give you a particular reason? Trying to understand and inform myself. Good luck
My lithotripsy was unsuccessful. They couldn’t seen the stones during the procedure. It was a huge waste of money and recovery time. I still have the stones I had before the procedure.
I looked up the chance pieces and it comes in so many different strengths I dont know which to get
Thank you. This is good information.
Did you try the Chanca piedra. I have a 5mm stone
Over 15 years I’ve passed at least 30 stones over the years as well I’ve had lithotripsy 7 times last august I had urendoscopy laser stone fragmentation basget stone removal with JJ stent not nice just had checkup 4 mill stone in left 5.2 and 6 mill in right hear we go again just don’t know what to do my younger and older brothers are having the same to all kidney stoners out there I feel for you
Please help. How do I pass a stone quickly??
I had stone removed in jan.had stent in for 5 weeks.had that removed and ct scan same day .week later they phoned to say scan showed small stone still in tube.after stent was removed passed lot of derie for day.then all clear and no after efects.they say i urgently need to get scan .but am in spain now.
left lower calyceal stone measuring 4mm,suggest medicines to dissolve
passed a stone 3 weeks ago-pain was excruciating, by time got through triage-pain settled, but ultrasound next day showed 6mm stone still in kidney; 2-3 litres of lemon/lime and water for 2.5 weeks and yesterday passed the 6mm stone that was measured to 5mm by time got to the bladder; pain was so bad I vomited three times on way the ED; at ED triage I was literally rolling around on the floor and wimpering please help me; the triage nurse just ignored me and it was the ward clerk who waved me in, but by time they arrived with morphine, pain had subsided-subsequently CT KUB shows two more measuring 4mm still in the kidney-back on 2-3 litres a day and cutting out all oxalate type foods;
I have a 0.34cm stone in my right kidney. Plz help me to pass it out. I do feel pains when urinating and vomit when the symptoms arise.
I have a 5.2mm kidney stone in the mid pole calyx region of my right kidney. I’ve increased my water intake till 4 to 5 litres a day. I’m taking various medicines like cystone, neeri tablets and apple cider vinegar.. I’ve been following this since the past 3 weeks.. I’ve just gone for another sonography and it shows no change… I’ve consulted different doctors here.. They saying to just continue the process… my friends advice me to have beer to get rid of it.. need to get this stone out!
Listen to your friends.
I had a 4MM stone, after taking flomax 3 days , it passed. the pain was swear in the beginning, doctor put me on Vacadin ( don’t know how to spell correctly), but I took only Advil 3-4 days instead of Vacadin.
Stone of 4.5 mm size in left kidney in lower calyx..how to passed out through urine
I have passed a 1.4 cm stone and my doc said its huge and i need lithotripsy or surgery but i eventually passed two stones one is 1.4 cm and another one 8 mm but this was 2 years ago and now i have diagnosed with a 2.3 cm stone in my right ureter,no pain or blood while urinating, taking bome remedies so tat the stone will eventually break and i pass it again wigbout any surgery,
Arif, you’re such a lucky fella. Those are HUGE stones you’re talking about!
I have a stone size 15mm in my right ureter at the lower crossing of liliac vessel.What to do.
have it surgicallly removed!
What was the home remedy that you used?
Arif you are so lucky , plz do share how you did that , I have 1 cm stone which ureteric lithotripsy couldn’t remove and now they want to go for something bigger . Plz also tell us how long did it take ?
Thanks
Assalam alaikum bhai,
good to hear that you passed stones .pl help me i am having 9mm in my left ureter and 7 mm in left kidney.how top pass it without surgery because 10 yrs back i had lithotripsy with 22 mm size stone in ureter.
pl guide me how to pass i am in saudi arabia and no treatment available here.
Mohammed Javeed
How did ya pass stones in Saudi without surgery? 🙏🙏