For other patients, who are a bit more lucky, we are able to locate the stone before it begins it’s journey down the ureter. Although most patients can pass a stone less than 4mm on their own, the size of this line (—), any bigger than that, and the stone is likely to get lodged, causing trouble.
When appropriate, we will give pain medicine, including Toradol, which is also relaxes the ureter, decreasing pain. We also use medications called alpha-blockers such as Uroxatral, Flomax, and Rapaflo, which can potentially dilate the ureter, allowing urine to be able to pass by the stone, reducing pain. In some lucky cases, the ureter dilates enough to pass the stone spontaneously. (No surgery!)
For others, with larger stone, complex anatomy, or other factors such as urinary infection, severe pain, ureteroscopy will be necessary to remove the stone.