Kidney stones (NICE)

Question 1

When should patients with acute renal colic receive investigation?

Answer 1

Within 24 hours

Question 2

What investigation is recommended for acute renal colic?

Answer 2

Non-contrast CT
Ultrasound if pregnant

Question 3

What is medical expulsive therapy and when would it be considered?

Answer 3

Alpha blockers
Distal ureter stones <10mm

Question 4

When would watchful waiting be considered for renal stones?

Answer 4

Asymptomatic stone
The stone is less than 5 mm or
The stone is larger than 5 mm and the person (or their family or carers, as appropriate) agrees to watchful waiting after an informed discussion of the possible risks and benefits.

Question 5

Recommended surgical management of renal stones <10mm

Answer 5

Shockwave lithotripsy

Question 6

Recommended surgical management of renal stones 10-20mm

Answer 6

Consider shockwave lithotripsy or uteroscopy

Question 7

Recommended surgical management of renal stones >20mm

Answer 7

Percutaneous nephrolithotomy

Question 8

Recommended surgical management of ureteric stones <10mm

Answer 8

Shockwave lithotripsy

Question 9

Recommended surgical management of ureteric stones 10-20mm

Answer 9

Uteroscopy

Question 10

When should surgical treatment be offered within 48 hours?

Answer 10

Pain is ongoing and not tolerated
OR
The stone is unlikely to pass