Hello Thnks for query .You are known to get recurrence of urinary stones mostly due to metabolic disorder . Now you have four stones in Left kidney bigger one of the size of 7 mm . Normally stone up to size of 8 mm can be expected to pass out spontaneously .However there are multiple factors that govern the passage of stone out 1) Shape of the stone 2) Diameter of mouth of calyx . The pain occurs even when the stone is in kidney and occurs when it gets impacted at the mouth of calyx causing distention of calyx due to accumulation of urine in calyx. As regards no of lithotripsy that one can be subjected to I would say that due to advanced technology and modern lithotripsy machines one can have ESWL for plenty of times and there is no danger to pancreas or any other organ . Since you have stone of a size of 7 mm and less you can expect them to pass out spontaneously . If they fail to pass down within a month you can go ahead for ESWL. Dr.Patil.