Do all patients with renal colic require urologic intervention to remove the stone?
Most patients with renal colic will pass the stone without surgical intervention. Stones <5 mm will pass without intervention 80% to 90% of the time; stones >6 mm pass only 25% of the time.
Pharmaceuticals, such as the alpha blocker tamsulosin or calcium channel blockers, which act as ureteral muscle relaxants, can be used to promote stone passage.
Corticosteroids may be used to reduce swelling and inflammation. Indications for emergent removal of an obstructing stone include fever, intractable pain, persistent nausea and vomiting, obstruction of a unilateral kidney, or a stone deemed unlikely to pass because of its size.
