Most kidney stones in men pass on their own with enough fluids, pain management, and time. Stones smaller than 5 mm have the highest chance of passing without intervention, while stones larger than that increasingly require medical or surgical treatment. What you can do right now depends on the size of your stone, where it’s located, and how severe your symptoms are.
What Passing a Kidney Stone Feels Like
The hallmark symptom is intense pain in your lower back, belly, or side, often radiating down toward the groin. In men, this pain can extend into the testicles as the stone moves through the ureter, the narrow tube connecting your kidney to your bladder. The pain typically comes in waves rather than staying constant, and it can shift location as the stone travels downward.
You may also notice blood in your urine (pink, red, or brown), a persistent urge to urinate, or burning during urination. Nausea and vomiting are common during the worst pain episodes. These symptoms alone don’t necessarily mean you need emergency care, but fever, chills, or an inability to keep fluids down are signs of a possible infection or blockage that needs immediate attention. An infected, obstructed kidney can cause serious damage quickly.
Passing Small Stones at Home
If your stone is under 5 mm, your doctor will likely recommend watchful waiting, sometimes called “observation” or “conservative management.” The reported rates of spontaneous passage vary widely in clinical studies, ranging from 8% to 84% depending on stone size, location, and the population studied. But the general rule holds: smaller stones pass more reliably, and the process can take anywhere from a few days to several weeks.
The single most important thing you can do is drink enough fluid to produce about 2.5 liters (roughly 80 ounces) of urine per day. That’s significantly more than most people drink normally. Water is the best choice. This volume keeps your urinary tract flushed and helps push the stone along. Spread your intake throughout the day and night, since stones don’t stop moving while you sleep.
Over-the-counter pain relievers like ibuprofen are typically the first line for managing the waves of pain. Ibuprofen also reduces inflammation in the ureter, which can make passage easier. Your doctor may prescribe stronger pain medication if needed.
Alpha-Blockers for Faster Passage
For stones in the 5 to 10 mm range, your doctor may prescribe an alpha-blocker, a type of medication that relaxes the smooth muscle in your ureter to widen the passage. A large meta-analysis of randomized controlled trials found that this medication significantly improved stone expulsion rates and shortened the time to passage compared to no treatment. It’s most effective for stones lodged in the lower ureter, closer to the bladder.
Dissolving Uric Acid Stones Without Surgery
Uric acid stones are the only type of kidney stone that can actually be dissolved with medication. They account for roughly 5% to 10% of all kidney stones, and men who eat a lot of red meat or have gout are more prone to them. A CT scan without contrast can sometimes suggest a uric acid stone based on its density, and urine testing can confirm if your urine is abnormally acidic.
The treatment works by making your urine less acidic, which dissolves the uric acid crystals. The target is a urine pH between 6.0 and 7.0 (normal urine tends to be more acidic, around 5.5 to 6.0). Studies using potassium citrate as the primary alkalinizing agent demonstrated a 50% or higher rate of complete stone dissolution. This approach takes weeks to months, but it can eliminate stones entirely without any procedure. Your doctor monitors your urine pH with test strips and adjusts the dose accordingly.
Calcium oxalate stones, the most common type, cannot be dissolved this way. They require passage or removal.
When Surgery Becomes Necessary
Stones larger than 10 mm rarely pass on their own, and even stones between 5 and 10 mm may need intervention if they aren’t moving, if pain is unmanageable, or if they’re causing a blockage. Larger stone size and continued growth (1 mm or more per year) are both associated with a greater likelihood of needing a procedure.
The two most common procedures for stones up to about 1 cm are shock wave lithotripsy (SWL) and ureteroscopy (URS). Shock wave lithotripsy uses focused sound waves from outside your body to break the stone into small fragments you can pass naturally. It’s noninvasive and usually done as an outpatient procedure with sedation. Ureteroscopy involves passing a thin, flexible scope through your urethra and bladder up into the ureter, where the stone is either grabbed with a tiny basket or broken apart with a laser.
For stones located in the lower part of the kidney (the lower pole), ureteroscopy has a clear advantage. Studies show a median success rate of 81% for ureteroscopy compared to 58% for shock wave lithotripsy in this location. Current guidelines recommend against using shock wave lithotripsy as first-line treatment for lower pole stones between 1 and 2 cm. For very large stones (over 2 cm), a different approach called percutaneous nephrolithotomy is typically used, which involves a small incision in the back to access the kidney directly.
“Stone Breaker” Supplements Don’t Work
If you’ve searched for natural remedies, you’ve probably seen chanca piedra (marketed as “stone breaker”) and polyherbal blends like Cystone. The clinical evidence for these is weak. A review published in The Journal of Urology found that the one study on chanca piedra claiming a reduction in stone number was a single-arm study with no control group, failed to account for natural stone passage, and used ultrasound instead of CT for monitoring. No clinically significant changes in urine chemistry were observed. For Cystone, a well-designed study showed no improvement in stone size, stone number, or urine composition despite marketing claims.
Apple cider vinegar and lemon juice are also commonly recommended online. While citrate (found in lemons) does play a role in stone prevention, the amounts in dietary lemon juice are far lower than therapeutic doses of prescription citrate supplements. These home remedies are unlikely to dissolve or break up an existing stone.
Preventing the Next Stone
About half of people who form a kidney stone will form another within five to ten years, so prevention matters as much as treatment. The dietary changes that make the biggest difference are straightforward but require consistency.
Keep your fluid intake high enough to produce at least 2.5 liters of urine daily, every day, not just when you’re symptomatic. This is the single most effective preventive measure.
Limit sodium to under 2,300 mg per day (about one teaspoon of table salt). Sodium increases calcium excretion in your urine, which directly raises your risk of calcium-based stones. This means watching processed foods, restaurant meals, and canned soups, not just the salt shaker.
Reduce animal protein intake. Beef, chicken, pork (especially organ meats), eggs, fish, shellfish, and dairy all increase your risk when consumed in excess. Animal protein makes your urine more acidic and raises uric acid levels, promoting both calcium oxalate and uric acid stone formation. You don’t need to go vegetarian, but shifting some of your protein intake toward plant sources helps.
One counterintuitive point: don’t restrict calcium. Low-calcium diets actually increase stone risk because dietary calcium binds oxalate in your gut before it reaches your kidneys. Get your calcium from food rather than supplements, and eat calcium-rich foods alongside oxalate-rich foods (spinach, nuts, chocolate, tea) so they bind together during digestion.
If you’ve had more than one stone, ask your doctor about a 24-hour urine collection test. This identifies your specific metabolic risk factors, whether that’s high calcium, high oxalate, high uric acid, or low citrate, so prevention can be targeted rather than generic.