From the Guidelines
Kidney stone symptoms in men typically include severe pain in the side, back, or lower abdomen that may come in waves and fluctuate in intensity, as well as other symptoms such as painful urination, hematuria, and nausea. According to the most recent study on acute onset flank pain-suspicion of stone disease (urolithiasis) published in the Journal of the American College of Radiology in 2023 1, men are more commonly affected than women, and the incidence increases with age until 60 years of age. The symptoms of kidney stones in men can be attributed to ureteral hyperperistalsis, irritation, and trauma to the ureter, which may result in hematuria and ureteral obstruction with resultant hydronephrosis.
Some common symptoms of kidney stones in men include:
- Severe pain in the side, back, or lower abdomen that may radiate to the groin or testicles
- Painful urination
- Blood in the urine (hematuria) giving it a pink, red, or brown color
- Cloudy or foul-smelling urine
- An urgent need to urinate frequently but passing only small amounts
- Nausea and vomiting
- Fever and chills if an infection is present
- Difficulty finding a comfortable position and restlessness due to pain
These symptoms occur because kidney stones are hard mineral deposits that form in the kidneys and cause irritation and blockage as they pass through the narrow urinary tract. As noted in the study 1, stone size and location have been shown to be important determinants in stone passage and the need for invasive management, with larger and more proximally located stones being associated with lower rates of spontaneous passage. If you experience severe pain, persistent vomiting, fever, or cannot pass urine, seek emergency medical care immediately as these may indicate a serious complication requiring prompt treatment.
From the Research
Kidney Stone Symptoms in Men
- Kidney stones are a common disorder, with an annual incidence of eight cases per 1,000 adults 2
- The first priority during an episode of renal colic is to rule out conditions requiring immediate referral to an emergency department, then to alleviate pain, preferably with a nonsteroidal anti-inflammatory drug 2
- Diagnostic workup consists of urinalysis, urine culture, and imaging to confirm the diagnosis and assess for conditions requiring active stone removal, such as urinary infection or a stone larger than 10 mm 2
Treatment Options
- Conservative management consists of pain control, medical expulsive therapy with an alpha blocker, and follow-up imaging within 14 days to monitor stone position and assess for hydronephrosis 2
- Alpha-blockers have been shown to increase expulsion rates of distal ureteral stones, decrease time to expulsion, and decrease need for analgesia during stone passage 3
- Alpha-blockers may increase stone clearance but probably also slightly increase the risk of major adverse events 4
Efficacy of Alpha-Blockers
- For ureteral stones ≤10 mm treated without lithotripsy, alpha-blockers increased clearance in all meta-analyses and one RCT versus control 5
- For ureteral or renal stones treated with lithotripsy, 4 RCTs and all meta-analyses found benefit with alpha-blockers compared with control 5
- Alpha blockers are supported by a growing body of evidence to be effective against nephrolithiasis in children, however large-scale, well-designed studies are needed to confirm these findings 6
Prevention and Management
- Lifestyle modifications such as increased fluid intake should be recommended for all patients, and thiazide diuretics, allopurinol, or citrates should be prescribed for patients with recurrent calcium stones 2
- Patients at high risk of stone recurrence should be referred for additional metabolic assessment, which can serve as a basis for tailored preventive measures 2