Management of Small Renal Stones

Spontaneous Passage Rates

• Stones <5mm have approximately 68% chance of spontaneous passage 1
• Most stones that will pass do so within 17 days (range 6-29 days) 2

Management Approach

• Observation with periodic evaluation is appropriate for a small renal stone 3, 4
• Medical expulsive therapy (MET) with alpha-blockers can increase stone passage rates by 29% 1, 2

Monitoring Requirements

• Follow with periodic imaging to monitor stone position and assess for hydronephrosis 3, 5
• Be alert for complications requiring intervention, such as uncontrolled pain 4, signs of infection or sepsis 5, development of obstruction 4, or inadequate renal function 5

Intervention Considerations

• Consider intervention if complications develop (infection, refractory pain, decline in renal function) 2