Symptoms of Ureteric Calculi

1. Pain (Ureteric/Renal Colic)

Pain location shifts as the stone descends the ureter — upper ureteric stones → loin to groin radiation; lower ureteric stones (near VUJ) → radiation to tip of penis/labia, with bladder symptoms.

2. Urinary Symptoms

• Haematuria — gross (visible) or microscopic; especially during colic episodes
• Urgency & Frequency — particularly with stones at or near the vesico-ureteric junction (VUJ)
• Calculuria — passage of sand, gravel, or small stones in the urine

3. Systemic Symptoms

• Nausea and vomiting — common during acute colic
• Fever with chills/rigors — suggests underlying urinary tract infection (UTI) complicating obstruction; constitutes a urological emergency
• Malaise and weight loss — seen with longstanding infection stones or renal failure

4. Asymptomatic Presentation

• Stones may be incidentally detected on imaging done for other reasons — increasingly common with widespread use of CT and ultrasound.

CT KUB Showing Urolithiasis at Various Levels

CT scans showing (A) bilateral hydronephrosis, (B) renal calculi with hydronephrosis, (C) ureteric calculus with proximal dilation, (D) bladder stone.

Symptom Summary by Stone Location

Red Flag Symptoms (Require Urgent Management)

• Fever + rigors (infected obstructed system — emergency decompression needed)
• Anuria/oliguria (bilateral obstruction or obstruction of single functioning kidney)
• Uncontrolled pain or vomiting