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Urinary Disorders

Kidney Stone Moving Back and Forth

02/16/2010

Question:

I had a CT Scan that showed a 3.4 stone and a 9mm stone. The smaller stone passed two days after the ER visit. A couple of weeks later, still in considerable pain, I had an X-ray showing the 9mm stone had moved into the ureter. A week later another X-ray showed that the stone had moved back into the kidney. (There was blockage when it was in the ureter.) Pain lessened, but has never gone away and it comes in waves varying in intensity. Sometimes the pain is quite strong and I think the stone is on the move. Question -Is it unusual for a stone to move back and forth like this and could it continue to move in this manner, and if so, could such movement cause damage my kidney? (Ewsl is scheduled.)

Answer:

Once a stone enters the ureter, it is uncommon but not unheard of for the stone to move back into the kidney. The transition from kidney to ureter is called the ureteropelvic junction. The renal pelvis is shaped like a funnel into the ureter. Stones frequently lodge at this point causing obstruction and may move back into the kidney if not embedded into the more narrow ureter with subsequent relief of pain. For the majority of patients, a 9 mm stone will not pass without intervention (ESWL, ureteroscopy, etc.). If the stone does become embedded and obstructs the kidney out-flow, then damage to the kidney will ensue. It is appropriate to proceed with treatment to avoid this outcome.

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Response by:

James F Donovan, Jr, MD James F Donovan, Jr, MD
Professor of Surgery
Director of UC Urology
College of Medicine
University of Cincinnati