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Where Do Kidney Stones Get Stuck

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Kidney stones can be incredibly stubborn and have a knack for getting stuck while passing. Sometimes kidney stones get stuck due to their characteristics such as shape, size, or jagged nature. Other times, kidney stones get stuck due to natural narrowing in our urinary tract. The focus of today’s discussion will be identifying the three location that kidney stones have the highest likelihood of getting stuck and what we can do to minimize the chances of this or address the blockage if it occurs.

Fortunately, when a kidney stone gets stuck, it’s temporary. Even while temporary, it is in our best interest to keep kidney stone moving. When they do get stuck, kidney stones can cause problems that we want to avoid such as hydronephrosis and more renal colic pain (view video). Hydronephrosis is when urine backs up into the kidneys causing swelling. If left unaddressed, it can lead to renal failure and infection. And, it’s painful!

Now, there are varying degrees of hydronephrosis. And, given that you have a kidney stone, you already have what would be considered “mild hydronephrisis.” So, nothing to get too excited about here. But, as we will discuss, there are a few things to be aware of that can point to problems. Severe hydronephrosis is very-very rare.

When it comes to the locations where kidney stones have the highest likelihood to get stuck, there are two major and one minor location. The easiest way to think about this is to break the urinary tract into three different pieces: upper, mid, and lower. They are as follows: 

  • Upper: Ureteropelvic Junction (UPJ) where the kidney flows into the ureter
  • Mid: Ureteral Crossing of Iliac Vessels (CUIV) where the the arteries that provide blood to the lower body cross over the ureter
  • Lower: Ureterovesical Junction (UVJ) where the ureter flows into the bladder

The two major sites are the Ureteropelvic Junction (UPJ) and the Ureterovesical Junction (UVJ). There is an abrupt reduction in the internal diameter of the ureter at the these two locations which can cause stones to get stuck. The minor location is where the Iliac vessels (arteries) cross over the ureter (CUIV) causing an external compression of the ureter which can cause stones to get caught.

As mentioned earlier, stones getting stuck and causing Hydronephrosis is nothing to get too excited about. It is a part of the process of passing a stone naturally. However, this does not mean that we ignore the feedback that our body is providing us. We must be aware. Here is a list of things to be attentive to while passing your stone naturally:

  • Persistant Renal Colic Pain
  • Hydronephrosis
    • Nausea
    • Difficult/pain urinating
    • Fever
    • Kidney region tender to touch

Stone size will play a big part of how closely you will need to pay attention during this process. The average human has a ureter with an internal diameter of 4-5mm. However, the ureter is VERY flexible and expand and constricts as they body sees fit. So, it can adapt to a wide range of stone sizes and shapes. 

NOTE: the size of your stone provided by your Doctor/Urologist is likely the overall length of your stone. This number is the scariest and what is communicated. So, that “9mm” kidney stone is really 9mm long and maybe 4-5mm in width/diameter (completely passable). This is why it’s important to have your stone evaluated with a CT scan versus an X-ray or Ultrasound which are commonly used. 

Passing a kidney stone naturally may seem like an arduous process. But, it doesn’t have to be. There are just a few things that we need to keep an eye on to ensure a successful passing with as little complication as possible. See below for a few things that you can do to help you stack the deck in your favor while passing a kidney stone:

  • Stay hydrated by drinking 3-4L (96-128oz) of water per day
  • Manage inflammation through natural supplements such as CLEANSE or Tylenol/Acetaminophen 
  • Increase urine flow with help of natural diuretic like dandelion root tea or OTC water pill
  • Jump & Bump method (view video)
  • Pressure method (view video)

If you are diligent about watching for signs of problems and set yourself up for success through the activities just mentioned, you can pass your kidney stone (up to 9mm) naturally with very little issue. Remember, you may come across points where you’re in pain, this will likely be temporary. But, listen to your body. If you feel like there’s a more serious issue at hand, seek professional help.

 

Citations

  • Moon YJ, Kim HW, Kim JB, Kim HJ, Chang YS. Distribution of ureteral stones and factors affecting their location and expulsion in patients with renal colic. Korean J Urol. 2015;56(10):717-721. doi:10.4111/kju.2015.56.10.717 [VIEW PAPER]

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