Kidney Stone Management

Natural History and Treatment

• The American Urological Association recommends medical expulsive therapy with alpha-blockers to increase passage rates of medium stones (5-10 mm) to 77.3% compared to 54.4% with placebo 1
• Stones larger than 10 mm have low spontaneous passage rates and require surgical management, as recommended by the American Urological Association 2, 3, 4
• The European Association of Urology recommends ureteroscopy as a treatment option, with a 94% stone-free rate for distal ureteral stones, 86% for mid-ureteral stones, and 81% for proximal ureteral stones 3, 4

Asymptomatic Stone Passage Rates

Spontaneous Passage Rates

• 68% of stones ≤5 mm pass spontaneously in patients under observation (95% CI: 46% to 85%) 5, 6
• 47% of stones 5-10 mm pass spontaneously (95% CI: 36% to 59%) 6
• Ureteral stones cause obstruction and distension that typically produces at least some discomfort 5