Ureteral Stones: Symptoms, Diagnosis, and Concerns

Urethral stones

On the 22nd, I underwent a urethral imaging procedure.
In the afternoon, the outpatient doctor said that no stones were observed and suggested that they might have already been expelled.
However, I have been experiencing abdominal soreness for the past few days.
Is it possible for the pain to recur so soon after the procedure? Additionally, if I did not drink a lot of water after the contrast agent was administered, will it still be expelled from my body? Could this have any impact on my kidneys, such as causing atrophy or other side effects?

Ku Ge, 20~29 year old female. Ask Date: 2012/06/28

Dr. Li Yilun reply Urology

Is the examination you underwent performed with a contrast agent injected intravenously? Such examinations are typically referred to as intravenous pyelography, primarily used to assess the kidneys, ureters, and bladder for any abnormalities.
No significant findings were noted.
If there are indeed urinary stones, they are usually small in size, which increases the likelihood of natural passage; however, it is important to emphasize that this is a higher probability, but it does not guarantee immediate passage, nor does it mean that passing the stones will be painless.
Therefore, if you are considering natural stone passage, please drink plenty of water.
If symptoms persist, it is essential to return for follow-up and treatment.
The contrast agent is typically eliminated by individuals with normal kidney function over time and usually does not cause adverse effects.
Patients with stones should also increase their fluid intake, which aids in the elimination of the contrast agent, so please drink more water.
However, different patients have different conditions, and it must be noted that it is impossible to assess the condition based solely on your brief description.
Therefore, it is emphasized that if symptoms do not improve or worsen, it is still advisable to seek consultation and examination from a professional physician to avoid delaying the diagnosis.
Physicians often need to inquire about medical history, perform visual examinations, palpation, and other assessments to confirm the diagnosis and determine the appropriate treatment.

Reply Date: 2012/06/28

More Info

Understanding ureteral stones is crucial for managing symptoms, diagnosis, and treatment options effectively. Ureteral stones, also known as urinary stones or kidney stones, can cause significant discomfort and lead to various complications if not addressed properly.

Symptoms of Ureteral Stones
The symptoms of ureteral stones can vary depending on the size and location of the stone. Common symptoms include:
1. Severe Pain: Often described as sharp or cramping, this pain typically occurs in the lower back or side and may radiate to the abdomen or groin.

2. Hematuria: Blood in the urine is a common sign, which may appear as pink, red, or brown urine.

3. Frequent Urination: A person may feel the urge to urinate more frequently, often with little urine output.

4. Nausea and Vomiting: These symptoms may accompany the pain due to the body's reaction to the obstruction.

5. Urinary Tract Infections: Symptoms such as fever, chills, and cloudy urine may indicate an infection.

Diagnosis
Diagnosis of ureteral stones typically involves a combination of patient history, physical examination, and diagnostic imaging. Common methods include:
1. Urinalysis: This test checks for blood, crystals, and signs of infection in the urine.

2. Ultrasound: A non-invasive imaging technique that can detect stones and assess kidney swelling.

3. CT Scan: A more sensitive imaging method that can identify stones that may not be visible on X-rays.

4. X-ray: While useful, not all stones are visible on standard X-rays, particularly those made of uric acid.

Concerns Regarding Stone Passage and Imaging
In your case, the doctor mentioned that no stones were visible during the imaging, which could indicate that the stone has passed. However, persistent abdominal pain may suggest that a stone is still present or that there are residual fragments causing irritation. It is not uncommon for symptoms to fluctuate, and it is essential to monitor them closely.

Regarding the use of contrast agents during imaging, it is crucial to stay well-hydrated. If you do not drink enough water, the contrast agent may not be adequately cleared from your system, potentially leading to kidney stress. In rare cases, this can result in acute kidney injury, especially if there are pre-existing kidney issues. However, the kidneys are generally resilient, and with proper hydration, the risk of long-term damage is minimal.

Potential Complications
If ureteral stones are not addressed, they can lead to complications such as:
1. Hydronephrosis: Swelling of the kidney due to urine buildup, which can cause kidney damage if not resolved.

2. Infection: Stones can obstruct urine flow, leading to urinary tract infections that may require antibiotics.

3. Chronic Pain: Ongoing discomfort can significantly affect quality of life.

Treatment Options
Treatment for ureteral stones depends on the size, location, and symptoms. Options include:
1. Conservative Management: For small stones, increased fluid intake and pain management may be sufficient for the stone to pass naturally.

2. Medications: Alpha-blockers can help relax the ureter and facilitate stone passage.

3. Surgical Interventions: If stones are large or causing significant symptoms, procedures such as ureteroscopy, shock wave lithotripsy (ESWL), or percutaneous nephrolithotomy may be necessary.

Conclusion
In summary, understanding the symptoms and diagnostic processes related to ureteral stones is essential for effective management. If you continue to experience abdominal pain or other symptoms, it is advisable to follow up with your healthcare provider for further evaluation and potential imaging. Staying hydrated is crucial, especially when undergoing imaging with contrast agents, to minimize any risk to your kidneys. If you have concerns about your symptoms or the effects of imaging, do not hesitate to discuss them with your doctor for tailored advice and treatment options.

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