How Long Will My Kidney Stones Last, and Will They Pass?

By: Jay Fuletra, MD

An estimated 10% of all people develop a kidney stone at some point in their lives…and nearly 20% of those kidney stones do not go away on their own.

On the upside, that means eight in 10 stones can and do pass naturally through the body in urine. In 6.5% cases of kidney stones, research finds that patients never even feel the symptoms.

What are six signs of kidney stones?

The reason stones can pass on their entails several variables, including what makes them in the first place. Kidney stones start as tiny crystal-like concentrations of calcium, sodium, uric acid, oxalate, and other minerals that your kidneys naturally excrete. When these minerals are properly balanced with liquid, your kidneys can cleanse them out with urine.

However, if the ratio of minerals to liquid gets too high, the compounds will stick together and form stones. This process can takemonths or even years, and some stores remain in the kidneys for years longer undetected (silent stones).

But typically, stones will move from the kidneys to the ureter, the tube that carries urine to the bladder, and can make themselves known.

How Size Matters in How Long Stones Stay in the Kidneys

A kidney stone’s location and size largely determine how long it will take to pass, if it is able to. Here are the odds based on size:

• Stones of 1 to 4 millimeters in diameter (up to an eighth of an inch), often pass on their own in a few days to six weeks; the average time is 31 days, according to Healthline. This is possible because the stones are still smaller in diameter than the ureter.
• Stones of 4 to 6 millimeters can exceed the width of the ureter and therefore are more likely to demand medical treatment. That said, nearly 60% do pass in urine with an abundant amount of water (2.5 to 3 liters, or 3 quarts) and the aid of medication. This takes 45 days on average.
• Just 20% of stones larger than 6 millimeters pass in urine, and it can take about a year to do so. Usually, these stones need to be broken up and removed.

Symptoms of stones that have trouble passing include:

• Pain in your side (flank), lower back, and abdomen
• Urination that burns
• A more frequent and intense need to pee (but sometimes producing little)
• Cloudy and/or bad-smelling pee
• Blood in your urine (hematuria)
• Fever and chills
• Nausea and vomiting (often from pain)

Risks and Causes of Hard-to-Pass Kidney Stones

If you develop a kidney stone, regardless of size, you can take some measures to help it pass. But first, it’s helpful to know the contributing factors.

Dehydration and diet are common determinants behind kidney stones. Consuming large amounts of animal proteins including red meat and poultry can raise your uric acid levels. Foods high in processed salt and sugar can increase sodium and oxalate levels, while calcium helps lower oxalates. Colas add on the phosphates.

Other factors include certain medications, recurrent urinary tract infections, and family history.

Your First Paths to Kidney Stone Treatment: Letting it Pass

Your treatment approach to a stone depends on your symptoms and its size and location. Your urologist might perform urine and blood tests as well as imaging to determine the stone’s size and location.

When stones are small and the pain manageable, your doctor will likely suggest they pass naturally, with the aid of water and nonsteroidal anti-inflammatory drugs (NSAIDs) such a ibuprofen. Depending on the stone’s size, you might be prescribed the alpha blocker tamsulosin (Flomax) to relax the ureter above your bladder. This will help the stone move through more comfortably.

Your doctor also will advise on helpful dietary changes, including eating more fruits and vegetables and less salt and animal protein, and adding drink supplements, such as Crystal Light, to reduce stone risk.

Again, this approach can take up to six weeks or more but it can prevent medical intervention, including surgery.

Kidney Stone Medical Procedures: What to Expect

In cases where a kidney stone does not pass or blocks the urinary path, it likely will need to be broken down and removed. This can be accomplished non-invasively (no incisions) or through outpatient surgery.

Holding off on kidney stone removal will likely lead to unmanageable pain and can trigger repeat urinary tract infections (UTIs), a kidney infection, kidney swelling (hydronephrosis), and chronic kidney disease. In severe cases, a urinary infection can develop into the life-threatening disease sepsis and require a catheter (tube) to drain the infected urine, or dialysis.

The most common options for stone removal are:

Shockwave lithotripsy (ESWL) – This incision-free procedure breaks up stones using targeted shock waves from outside the skin. The urologist accomplishes this with the visual guidance of X-ray or ultrasound imaging. The repeated waves fragment the stones into pieces small enough to pass in your urine. See how a lithotripsy is performed here.

Ureteroscopy – Here is another incision-free, outpatient option that breaks stones down in the ureters and kidneys, but in this case typically removes them as well. The doctor inserts a slim, fiber-optic scope (a ureteroscope) into the urethra to reach the bladder and ureter. The scope then administers a laser to dissolve the stone and the bits are removed with a basket-like device.

Percutaneous stone removal (nephrolithotomy or PCNL) – For kidney stones larger than 2 centimeters, percutaneous (through the skin) stone removal is the standard approach. Here, the surgeon threads a fiber-optic scope called a nephroscope into the affected kidney through a small incision in the back. The doctor breaks the stone up with sound waves and suctions it out. A temporary catheter is inserted to drain urine, and you will likely require a hospital stay. This procedure also can be performed robotically, or laparoscopically, which requires a smaller incision through the abdomen.

How to Help Kidney Stones Go Away

Ready to get rolling? Here are a few tips to help kidney stones pass on their own, as well prevent kidney stones from forming:

• Drink plenty of water. Not colas or caffeine, but water, especially when exercising.
• Cut back on stone-forming ingredients. This includes foods heavy in salt, sugars, and phosphates as well as animal proteins. These six foods are good for the kidneys.
• Eat the right amount calcium for your age. Calcium helps manage oxalate levels.

Your odds of developing a kidney stone might be “just 10%,” but your habits can raise or lower that risk. Small choices every day can save you from big pain in the future.

Curious to know more? You can click here to learn more about kidney health, including stones and tumors. If you’ve experienced any of the symptoms described in this blog, contact MidLantic Urology to schedule an appointment at one of our convenient locations.