尿管結石による痛み：初期の自己管理

最終更新日： 2026年5月18日

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Ureteric stone pain is one of the most severe pains the human body can experience. It occurs suddenly when a stone acutely occludes the ureter — a small tube organ approximately 25 cm long that transports urine from the kidneys to the bladder. Because the ureter’s diameter is as narrow as 4 mm, any stone larger than this may obstruct it and trigger intense flank pain.

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The location of the referred pain can help localize the stone:

1. Flank pain radiating to the testicle – suggests obstruction at the mid-ureter
2. Flank pain radiating to the groin area – suggests obstruction at the lower ureter

A ureteric stone originates from a kidney stone that travels from the renal pelvis into the ureter. If lucky, the stone passes spontaneously with urine without any pain. If not, ureteric stone obstruction causes severe pain that peaks within 1–2 hours of onset. The three most common obstruction sites are the ureteropelvic junction (kidney-ureter junction), mid-ureter, and ureterovesical junction (ureter-bladder junction, the narrowest point).

The gold standard imaging is a non-contrast CT scan, which provides: stone location, stone size, severity of obstruction (ureteral edema or kidney injury), and stone density (for treatment planning). Ultrasound and plain X-ray are useful screening tools but are not accurate enough for procedural planning.

Initial self-management during ureteric stone pain

• Anti-inflammatory drugs (NSAIDs) – First-line pain control for ureteric stone pain. NSAIDs also reduce pressure in the obstructed ureter. Important: only use if you have no history of NSAID allergy or renal impairment. If contraindicated, Acetaminophen (Paracetamol) is a safe alternative.
• お水をたくさん飲んでください – Adequate hydration helps facilitate stone movement and reduces pain. Patients with ureteric stone pain often become dehydrated from vomiting and reduced appetite, which can trap the stone and prolong pain. All US and European guidelines recommend maintaining good hydration during active ureteric stone episodes.

Self-management is only an initial recommendation and does not guarantee spontaneous stone passage. If you experience ureteric stone pain, the best course of action is to go to the emergency room promptly for medical assessment and treatment.

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Frequently Asked Questions About Ureteric Stone Pain

What does ureteric stone pain feel like and where is it felt?

Ureteric stone pain presents as sudden severe flank pain (loin pain) that typically peaks within 1–2 hours of onset. The pain may radiate depending on the stone location — stones in the mid-ureter often cause pain radiating to the testicle (in men), while lower ureteric stones cause pain radiating toward the groin. The pain is often described as colicky (comes in waves) and is frequently associated with nausea, vomiting, and the inability to find a comfortable position.

What can I do at home when ureteric stone pain strikes?

The two key initial self-management steps are: (1) Take an NSAID (anti-inflammatory) such as Ibuprofen or Diclofenac for pain control and to reduce ureteral pressure — only if you have no allergy or kidney disease; use Acetaminophen as an alternative if NSAIDs are contraindicated. (2) Drink plenty of water to stay hydrated and help facilitate stone movement. However, these are temporary measures. The safest approach is to go to the emergency room promptly for proper evaluation and treatment.

Why is CT scan needed for ureteric stone diagnosis?

A non-contrast CT scan is the gold standard because it provides comprehensive information that is critical for treatment planning: the exact stone location, stone size (which determines spontaneous passage probability), severity of ureteral obstruction and kidney injury, and stone density (Hounsfield units) which helps predict response to shock wave lithotripsy vs. ureteroscopy. Ultrasound and plain X-ray can screen for stones but are not accurate enough to reliably guide clinical decision-making.

If you are experiencing ureteric stone pain or have been diagnosed with a kidney or ureteric stone, Dr. Soarawee Weerasopone offers specialist consultations at Bangkok Hospital Headquarters. 診療をご予約.

**免責事項:** このコンテンツは、バンコク病院本部の認定泌尿器科医であるSoarawee Weerasopone博士によって作成およびレビューされました。教育目的のみのものであり、医学的アドバイスを構成するものではありません。いかなる医療処置を開始する前にも、必ず資格のある医療専門家にご相談ください。.