This protocol applies when initial acute treatment has not produced adequate pain control or led to spontaneous stone passage within the expected window. The next step involves a different level of intervention.
The prior line used Ketorolac (intramuscularly) to control acute pain and allow spontaneous stone passage. Escalation to the current protocol is indicated when adequate pain relief is not achieved, or when spontaneous stone passage does not occur within 4 to 6 weeks.
When the stone fails to pass on its own, the management shifts toward a specialist-led, procedural pathway for stone removal. The full protocol specifies the criteria and approach in detail.
Kidney stone removal confirmed on imaging.
If the stone does not pass spontaneously, the patient should be referred to a urologist for active stone removal.
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