Men pass kidney stones through the urinary tract, a process that can take anywhere from a few days to several weeks depending on the stone’s size. The stone travels from the kidney through a narrow tube called the ureter, drops into the bladder, and finally exits the body through the urethra during urination. For men, the urethra is longer than in women (about 8 inches versus 1.5 inches), but the most painful part of the journey is actually the ureter, not the urethra. Most stones under 5 mm pass on their own, though larger stones may need medical help.
The Four Stages of Passing a Stone
A kidney stone forms inside the kidney itself, often sitting there without causing any symptoms at all. The trouble starts when it begins to move. The passage process follows a predictable path through four stages, though not every stage causes the same level of discomfort.
Stage 1: The stone enters the ureter. This is where the real pain begins. The ureter is only about 3 to 4 mm wide, so even a small stone can stretch and irritate the walls as it passes through. The kidney may also swell with backed-up urine, a condition called hydronephrosis. This stage typically produces the most intense pain.
Stage 2: The stone moves through the ureter. As the stone travels down, pain shifts location. When the stone is in the upper ureter near the kidney, you’ll feel sharp pain in the flank and back. As it moves lower, the pain migrates toward the groin and lower abdomen. This shifting pain is actually a useful signal: it means the stone is progressing downward.
Stage 3: The stone reaches the bladder. Once it drops into the bladder, the severe pain usually eases significantly. You may feel a frequent, urgent need to urinate, along with pressure in the lower abdomen.
Stage 4: The stone exits through the urethra. During urination, the stone is pushed out of the bladder and through the urethra. Despite the urethra being longer in men, this final stage is often less painful than the ureter portion because the urethra is more flexible and wider at most points. You might feel a brief sting or burning sensation, and many men report they barely notice the stone coming out.
What the Pain Actually Feels Like
Kidney stone pain, called renal colic, is frequently described as the worst pain a person can experience. It comes in waves rather than staying constant, with intense cramping that builds to a peak over 20 to 60 minutes, then eases before returning. The waves happen because the ureter contracts around the stone, trying to squeeze it downward, similar to how the intestines move food along.
The classic pattern is severe, sudden-onset pain that radiates from the flank to the groin. You may also experience nausea or vomiting, blood in the urine (which can look pink, red, or brown), and a persistent feeling that you need to urinate even when your bladder isn’t full. Restlessness is common. Unlike many types of pain where lying still helps, people with kidney stones typically can’t find a comfortable position and tend to pace or shift constantly.
How Stone Size Affects Your Chances
The single biggest factor in whether a stone will pass on its own is its size. Research published in the American Journal of Roentgenology tracked spontaneous passage rates by stone diameter:
- 2 mm: 72% pass without intervention
- 4 mm: 72% pass without intervention
- 5 mm: 60% pass without intervention
- 6 mm: 72% pass without intervention
- 7 mm: 47% pass without intervention
- 9 mm: 33% pass without intervention
- 10 mm or larger: 27% pass without intervention
Stones under 5 mm generally have the best odds and may pass within one to two weeks. Stones between 5 and 7 mm are a gray zone where your doctor may recommend waiting with medical support or proceeding to a procedure. Anything over 10 mm rarely passes on its own and typically requires intervention.
Location matters too. A stone that’s already in the lower ureter near the bladder is much more likely to pass than one stuck near the kidney, regardless of size.
What Helps a Stone Pass Faster
Staying well hydrated is the most straightforward thing you can do. Drinking enough water to produce about 2 to 2.5 liters of urine per day helps push the stone along and keeps the urinary tract flushed. That translates to roughly 8 to 10 glasses of water daily, though during active stone passage you may want to drink even more. The goal is to keep urine dilute and flowing steadily.
For stones larger than 5 mm, doctors often prescribe a medication that relaxes the smooth muscle in the ureter, making the tube wider and allowing the stone to pass more easily. A large meta-analysis in The Journal of Urology found this approach increased the stone passage rate by 44% for stones over 5 mm. It also shortened the time to passage and significantly reduced the episodes of intense pain. Interestingly, for stones 5 mm or smaller, the medication didn’t make a meaningful difference, likely because those stones are small enough to pass without extra help.
Pain management is the other critical piece. Over-the-counter anti-inflammatory pain relievers are typically the first line, as they reduce both pain and swelling in the ureter. Your doctor may prescribe stronger options if needed. Applying heat to your back or side can also provide some relief between pain waves.
How Doctors Diagnose and Track the Stone
If you show up with symptoms of a kidney stone, the standard diagnostic tool is a CT scan without contrast dye. CT has high sensitivity and specificity for detecting stones in the ureter, which is why it’s recommended as the first-line imaging technique. It can pinpoint the stone’s location, measure its size, and reveal whether the kidney is swelling from backed-up urine.
Many hospitals now use low-dose CT protocols that deliver less radiation while still catching the important details. These scans correctly identify stones 5 mm or larger about 76% of the time, though they can underestimate size by up to 20%. That margin matters, because a stone measured at 4.5 mm on a low-dose scan might actually be 5.5 mm, which could change the treatment approach. Your doctor may factor in this uncertainty when deciding whether to wait or intervene.
When a Stone Won’t Pass on Its Own
Most small stones pass within a few weeks, but certain situations call for a procedure. If the stone hasn’t moved after four to six weeks, if the pain becomes unmanageable, or if you develop signs of infection (fever, chills, cloudy or foul-smelling urine), waiting is no longer the right approach.
A blocked ureter can cause the kidney to swell with urine. Symptoms of this include persistent pain in the side and back that radiates to the groin, nausea, vomiting, blood in the urine, and fever. Prolonged obstruction can damage the kidney, so this isn’t something to tough out indefinitely.
The two most common procedures are shock wave therapy, which uses sound waves from outside the body to break the stone into smaller fragments, and ureteroscopy, where a thin scope is passed through the urethra and bladder to reach and remove or laser the stone directly. Both are typically outpatient procedures with recovery times of a few days to a week. The meta-analysis on muscle-relaxing medications also found that patients who took them were 32% less likely to need surgical intervention, so medication can sometimes help you avoid a procedure altogether.
What to Do While You’re Passing a Stone
Your doctor will likely ask you to strain your urine through a mesh cup or filter every time you urinate. Catching the stone allows it to be analyzed in a lab, which identifies what type of stone it is and helps guide prevention strategies so you’re less likely to form another one. About half of people who pass a kidney stone will develop another within five to seven years without changes to diet or fluid intake.
Keep track of your symptoms as the stone moves. Pain shifting from your back down toward your groin is a good sign. A sudden stop in pain can mean the stone has either passed into the bladder or the ureter has relaxed around it. If the pain disappears but you never see the stone come out, it may be sitting in the bladder and could pass later without you noticing, especially if it’s small. Many men report that the stone exits during urination as a small, hard grain that they hear “clink” against the toilet or feel briefly in the urine stream.