Ureteric Stones
A ureteric stone is a stone on the move — that movement produces the classic renal colic and decides management: will it pass on its own, and is it safe to wait?
The big picture
A ureteric stone is a stone on the move — and that movement is what produces the classic renal colic and what decides management. The two questions are always the same: will it pass on its own (a function of size and position), and is it safe to wait (a function of obstruction and infection). Get those right and most ureteric stones never need surgery.
The framework: ureteric stones present with colic that refers along the ureter; management hinges on size-based passage prediction, medical expulsive therapy, the infection/obstruction emergency, and the choice between ureteroscopy and SWL when intervention is needed.
Mechanism pathway
Tap any step to see why it happens.
Ureter — course & three narrowings
The ureter — course & the three constrictions
The ureter is ~30 cm long and follows a smooth S-curve from the renal pelvis to the bladder. It has three natural narrowings — the classic sites where stones impact: ① the UPJ, ② where it crosses the iliac vessels, and ③ the ureterovesical junction (the narrowest).
Diagnostic algorithm
Each step answers one question. Tap to expand.
Board traps
Distal ureteric stones refer to the testis/labium/groin; sudden pain relief = passage into the bladder.
Passage by size: ~78% (1–4 mm), 60% (5–7 mm), 39% (8–10 mm); distal passes more easily.
Obstruction + infection = emergency → decompress first (overrides passage logic).
MET (tamsulosin) helps larger distal stones; NSAIDs are first-line analgesia.
Ureteroscopy vs SWL for intervention — URS has higher stone-free rates, especially for larger/harder/distal stones.