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🪨 Men's Health

Kidney Stones

Described as one of the worst pains imaginable — but highly treatable and preventable.

Kidney stones (renal calculi) affect up to 10% of adults and are significantly more common in men. The hallmark is sudden, severe, cramping pain radiating from the flank to the groin — often coming in waves. With the right treatment and dietary changes, most men recover fully and can prevent recurrence.

Signs and Symptoms

✓ Sudden severe loin (flank) pain — often described as the worst pain ever experienced
✓ Pain radiating from the back down to the groin or inner thigh
✓ Waves of pain (renal colic) — comes and goes with peristalsis of the ureter
✓ Blood in urine (haematuria) — pink, red, or brown urine
✓ Nausea and vomiting during the pain episode
✓ Frequent urge to urinate, burning on urination if stone near the bladder
✓ Fever and chills if a urinary infection is present alongside the stone

Risk Factors

When to Seek Help

NowSevere loin or flank pain with fever above 38.5°C — this suggests an infected kidney behind a blocked stone (obstructive uropathy), which is a urological emergency requiring hospitalisation
NowComplete inability to pass urine despite urge, or complete cessation of urine output — suggests bilateral obstruction
SoonFirst episode of renal colic — get an ultrasound to confirm the stone, its size, and its location; start pain management and hydration
RoutineHistory of stones with recurrence — metabolic workup and 24-hour urine collection to identify preventable risk factors

Tests & Diagnosis

🧪 Renal and Bladder Ultrasound
First-line imaging for kidney stones in Nigeria — widely available, no radiation, identifies stones in the kidney and upper ureter, and detects hydronephrosis (kidney swelling from blocked urine flow). Small stones in the mid and lower ureter may be missed on ultrasound.
🧪 Urine Analysis and Culture
Checks for blood (haematuria — present in >80% of stone episodes), infection (pyuria, nitrites), and urinary pH. Alkaline urine suggests uric acid or struvite stones; acidic urine suggests calcium stones.
🧪 Kidney Function (Urea, Creatinine, eGFR)
A stone causing prolonged ureteric obstruction damages the affected kidney. Checking kidney function confirms whether renal damage has occurred and guides urgency of treatment.
🧪 Serum Uric Acid and Calcium
Elevated uric acid identifies men at risk of uric acid stones (especially those with gout). Elevated calcium (hypercalcaemia) suggests hyperparathyroidism or sarcoidosis as an underlying cause — important to identify as treatment is directed at the cause.
🧪 Stone Analysis
If a stone is passed, it should be collected and sent for composition analysis (calcium oxalate, uric acid, struvite, or cystine). The stone type guides specific dietary and pharmacological prevention strategies.

Treatment Options

1
Immediate pain relief
Diclofenac (NSAID) is the most effective first-line analgesic for renal colic — it reduces ureteric spasm as well as pain. Intravenous ketorolac or morphine for severe cases in hospital. Avoid paracetamol alone — it is insufficient for the severity of renal colic.
2
Medical expulsive therapy (tamsulosin)
Tamsulosin 0.4 mg daily relaxes the smooth muscle of the lower ureter, significantly increasing the chances of spontaneous stone passage for stones up to 10 mm in the lower ureter. Start within 24–48 hours of diagnosis; continue for up to 4 weeks.
3
High fluid intake
Drink 2.5–3 litres of water daily during and after a stone episode. Adequate hydration dilutes the urine and reduces the time a stone spends in the ureter. Lemon juice (citrate) alkalinises urine and dissolves calcium oxalate and uric acid stones gradually.
4
Shockwave lithotripsy (ESWL)
External shockwaves fragment stones into small pieces passable in urine. Effective for kidney stones and upper ureteric stones up to 2 cm. Non-invasive, day procedure. Available at urology centres in Lagos.
5
Ureteroscopy (URS) + laser fragmentation
A thin telescope is passed up through the urethra and bladder to the stone site; a laser fragments the stone into dust-like particles. Highly effective for ureteric stones of any size and for stones in all locations. Definitive treatment when medical management fails.

Frequently Asked Questions

Will my kidney stone pass on its own?
It depends on size and location. Stones smaller than 4 mm have an 80% chance of passing spontaneously within 4 weeks. Stones 4–6 mm have a 60% chance. Stones larger than 6 mm are unlikely to pass spontaneously and usually require intervention. Stones in the lower ureter (closest to the bladder) pass more easily than those in the upper ureter or kidney. Tamsulosin significantly improves the odds of spontaneous passage.
How do I prevent kidney stones from coming back?
The most evidence-based interventions: drink 2.5–3 litres of plain water daily (target pale yellow urine); reduce dietary salt; moderate animal protein intake; add lemon juice to water daily (citrate inhibits stone formation); reduce oxalate-rich foods (spinach, nuts, dark chocolate) only if you have calcium oxalate stones on analysis. For uric acid stones: alkalinise urine with potassium citrate and control uric acid with allopurinol. A 24-hour urine metabolic profile after the acute episode identifies your specific risk factors.
Is blood in my urine always a kidney stone?
No — haematuria (blood in urine) has many causes including urinary tract infection, kidney infection, bladder or prostate problems, and in older men, bladder cancer. A stone is likely if haematuria is associated with loin pain. Painless haematuria requires investigation to exclude bladder cancer — never dismiss it as "probably a stone" without proper workup.
Can gout cause kidney stones?
Yes — uric acid, the compound that crystallises in joints during gout attacks, can also crystallise in the urine and form uric acid kidney stones. Men with gout are at significantly elevated risk of uric acid stones. Management: allopurinol reduces uric acid production; potassium citrate alkalinises urine to dissolve existing uric acid stones; purine-restricted diet (less red meat, organ meat, alcohol). Treating gout aggressively also prevents renal stones in this group.

Related Pages

Blood in Urine Symptom GuideKidney Function Lab StoryWhat is eGFR?

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