Ureter stones are stones which were initially formed in kidneys that have become stuck in the ureters, which are the thin tubes that transport urine from the kidneys to the bladder. Such stones are typically formed when people do not drink enough water or other fluids, or have too much salt or animal protein in their diet, resulting in excessive minerals or salts in their urine that form crystals and grow into the stones.

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People have a higher risk of ureter stones when they:

• have a family history of the stones
• suffer from chronic bowel inflammation
• have had intestinal bypass operations
• have a history of medical conditions, such as cystic kidney diseases, urinary tract infections and hyperparathyroidism, where parathyroid glands in the neck produce excessive parathyroid hormone

Symptoms of ureter stones

While very small stones can pass out of the body in urine without being noticed, larger ureter stones can block the flow of urine from the kidneys to the bladder, causing the kidneys to swell and ureters to go into spasm. At this point, people may experience symptoms including:

• Sharp and severe pain in the side and back (below the ribs)
• Pain that radiates to the lower abdomen and groin
• Pain that comes in waves and fluctuates in intensity
• Pain or a burning sensation while urinating
• Blood in urine, causing urine to appear pink, red or brown
• Cloudy or foul-smelling urine
• A persistent need to urinate, urinating more than usual, or urinating in small amounts
• Fever and chills if the ureter stones have led to an infection

Diagnosing ureter stones

Doctors may carry out physical examinations, go through patients’ medical history, and conduct tests to diagnose ureter stones. These diagnostic tests can include:

• Imaging tests, such as X-rays, ultrasounds or computed tomography (CT) scans, which provide detailed images of the kidneys, ureters, bladder and urethra, to locate the stones

• Blood tests, which can reveal high levels of calcium or uric acid in the blood associated with the formation of stones

• Urine tests, to determine if there are too many stone-forming minerals and salts, or too few stone-preventing substances, in the urine

With information about the size and location of the stones, doctors can recommend an appropriate treatment to remove them.

This article has been verified medically by Dr Sam Peh, consultant urologist at Surgi-TEN Specialists, Farrer Park Hospital (Singapore).