How is pain characterized in nephrolithiasis?

Updated: Sep 16, 2021
  • Author: Chirag N Dave, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
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The location and characteristics of pain in nephrolithiasis include the following:

  • Stones obstructing ureteropelvic junction: Mild to severe deep flank pain without radiation to the groin; irritative voiding symptoms (eg, frequency, dysuria); suprapubic pain, urinary frequency/urgency, dysuria, stranguria, bowel symptoms

  • Stones within ureter: Abrupt onset of severe, colicky pain in the flank and ipsilateral lower abdomen; radiation to testicles or vulvar area; intense nausea with or without vomiting

  • Upper ureteral stones: Pain radiates to flank or lumbar areas

  • Midureteral calculi: Pain radiates anteriorly and caudally

  • Distal ureteral stones: Pain radiates into groin or testicle (men) or labia majora (women)

  • Stones passed into bladder: Mostly asymptomatic; rarely, positional urinary retention

See Presentation for more detail.

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