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Surgery versus Waiting

The key decision in patients who present with stones in the ureter is whether to operate or to treat expectantly with analgesia and Medical Expulsion Therapy.

Surgery is required for a stone in the ureter when:

  • The stone in the ureter is associated with a fever.┬áThis is a surgical emergency as a blocked kidney in association with a urinary infection is a life-threatening emergency which requires urgent therapy to unblock the kidney.
  • The stone in the ureter is in a patient who only has one functioning kidney.
  • The stone in the ureter is causing the overall kidney functioning to be compromised significantly. This can be ascertained by a blood test.
  • The stone in the ureter is causing ongoing severe pain which is intolerable or too persistent.
  • The patient has had enough of pain and waiting for the stone to pass.
  • The stone is larger than 5-6mm and is unlikely to pass spontaneously. It should be noted that some patients can pass stones larger than this (with pain).