Can Kidney Stones Go Away On Their Own?

By: Seyed Shayan A. Falasiri, MD

In any given year, an estimated one in 10 people is likely to develop a kidney stone. Some kidney stones are found incidentally and never even cause symptoms.

Could you be that lucky?

Kidney stones are exactly what the name implies: small rocks that develop from high concentrations of minerals, acids, and salts expelled from your kidneys. Normally, your kidneys flush these minerals and compounds out, but if they become too condensed, they can bind and form crystals, or stones.

Read about the six warning signs of kidney stones.

How long these stones stay in your kidneys and urinary tract might depend on their size and location, but they can take months or even years to form. When kidney stones are small, or up to an eighth of an inch in diameter (4 millimeters), they typically go away on their own within a few days to a couple of weeks. In fact, the majority of stones pass on their own.

Larger stones, on the other hand, can take weeks or months and might require medical intervention.

If you develop a kidney stone, regardless of size, your luck can improve with self-care and the guidance of a urologist, which I’ll explain.

What Causes Stones to Become Problematic

Stones form when your kidneys lack enough fluid to flush out calcium, sodium, uric acid, oxalate, and other minerals, and so these particles stick to each other. Dehydration is a common culprit, but your diet (especially if high in meat, sodium, phosphates, and sugars) and certain medications also contribute to stone formation.

Kidney stones can be as small as a grain of salt or as large as corn kernel, and they generally become problematic when they reach the diameter of a pencil eraser – 5 millimeters. At this size, they surpass the size of the ureter, the tube that carries urine from the kidneys to the bladder.

When this large, a stone can irritate or get lodged within the urinary tract and is less likely to pass unaided. Symptoms of a problematic kidney stone include:

• Pain that can be acute in you lower back, abdomen, and side (flank)
• Blood in your urine (hematuria)
• Burning urination
• More frequent and urgent urination
• An inability to urinate (from blockage)
• Fever or chills
• Nausea and vomiting (from pain)

Medications that Can Help You Pass Kidneys Stones

If you carry a stone of up to 5 millimeters, the odds are you can pass it at home with plenty of water (2.5 to 3 liters, or 3 quarts) while your urologist monitors the symptoms. Nonsteroidal anti-inflammatory drugs (NSAIDs) such a ibuprofen can help manage pain, or your doctor might prescribe medication.

If the pain is too much to bear, you might require hospitalized pain management and intravenous (IV) fluids to boost hydration and help flush the stones out.

Once a kidney stone reaches 5 to 10 millimeters, the chances of it passing on its own drop to 50%. In these cases, a urologist might prescribe the alpha blocker tamsulosin (Flomax), which can relax the area of the ureter right above your bladder so the stone can more easily and comfortably be carried out in your urine.

This process can take two to four weeks and save you from undergoing medical removal.

When is Surgery the Best Option?

If your stone does not go away on its own after six weeks, and depending on the stone’s size, location, and complications such as infection, it might need to be broken down and removed. Holding off on medical intervention too long puts you at risk of a blockage that can result in recurrent urinary tract infections (UTIs), swelling of the kidneys (hydronephrosis), and permanent kidney damage.

In severe cases, a kidney or ureter infection can develop into sepsis, a life-threatening disease that could require a ureteral stent or percutaneous nephrostomy tube to drain the obstruction.

Your doctor will run a series of tests to determine if the stones can pass on their own or need to be extracted. If your doctor thinks the stone needs to be removed, you can expect these options:

Shockwave lithotripsy (ESWL) – This incision-free, outpatient procedure is the least invasive option for removing stones of 2 centimeters or less. During the procedure, the urologist directs shock waves from outside your body toward the stones, guided by X-ray or ultrasound imaging. The repeated waves break the stones into small enough fragments to pass in your urine.

Ureteroscopy – Also for smaller stones, this incision-free, minimally invasive procedure breaks down stones in the ureters and kidneys and then removes them. The doctor reaches the stones using a thin camera-equipped tube (a ureteroscope) that is fed into the urethra, to the bladder, and up the ureter. A laser device that’s passed into the tube dissolves the stones, which are removed.

Percutaneous nephrolithotomy (PCNL) – When kidney stones are bigger than 2 centimeters in diameter, percutaneous nephrolithotomy is the preferred surgical approach. In this procedure, the surgeon feeds a slim, camera-equipped tube (a nephroscope) to the kidney through a narrow incision in the back. Small surgical tools in the scope break the stones down using lasers or ultrasound, and the pieces are suctioned out. A temporary catheter will drain urine, and you should expect a hospital stay. This procedure also can be performed robotically, which requires a smaller (laparoscopic) incision through the abdomen. Watch our video on how a percutaneous nephrolithotomy is performed at AUI.

What You Can Do To Make Stones Go Away

You can reduce your risk of developing stones, as well as help them go away on their own, by staying properly hydrated (aim for light yellow urine), cutting back on salts, sugars, and ultra-processed foods, and balancing the animal proteins you eat with the recommended amount of calcium.

Ask your doctor for guidance, and we are here if you need us.

Advanced Urology Institute offers several surgical and non-surgical treatment paths to removing and easing kidney stone symptoms. To consult one of our conveniently located specialists, request an appointment.