Watchful Waiting

Even though 85 percent of kidney stones are small enough to pass during urination, fewer than 50 percent of patients chose this option. A person with a normal-size ureter can usually pass a kidney stone with a diameter less than 5 mm (about 3/₁₆ of an inch) without significant pain or risk of kidney damage. Infection and blockage of the urinary tract are the primary complications associated with waiting for a kidney stone to pass. Long-term blockage of the urinary tract can lead to kidney damage. If the warning signs of a urinary tract infection or blockage develop--fever or chills and intense pain--it's time to seek medical attention.

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Most stones pass within 72 hours after the symptoms first appear. However, for some people, it can take weeks to pass a kidney stone, with an unpredictable pattern and degree of pain. Shape and location of the stone may give clues to how easily the stone will pass. Some people experience only momentary and tolerable pain; for others, passing the stone can trigger intense and persistent pain. Because of this unpredictability, most patients prefer to have their kidney stone removed by a urologist rather than wait for passage.For other people, waiting for a kidney stone to pass may not be practical. For example, airline pilots or heavy-quipment operators may want to avoid a sudden attack of incapacitating abdominal pain at work.

The guidelines for waiting for a kidney stone to pass include:

• Drink at least 3 quarts of water per day.
• Stay physically active.
• Use pain medication as recommended or prescribed by your doctor.
• Urinate through a strainer to recover the stone for analysis.
• If fever or chills develop or symptoms (pain) worsen, seek out immediate medical attention.