This protocol addresses patients with renal colic caused by a distal ureteral stone measuring 5 to 10 mm in diameter — a size range where spontaneous passage is uncertain and a structured management pathway is required.
First-line management for distal ureteral stones 5 to 10 mm includes ketorolac for pain relief together with medical expulsive therapy using tamsulosin or doxazosin. When spontaneous stone passage within 4 to 6 weeks is not achieved, or when adequate pain reduction is not reached, escalation to a further management step is indicated.
Once conservative measures have failed to result in stone passage, the pathway moves to a specialist-directed intervention. The complete structured regimen — including the specific approach and decision criteria — is available in the full protocol.
Kidney stone removal confirmed on imaging.
These medications should be offered to patients with distal ureteral stones 5 to 10 mm in diameter.
If the stone does not pass spontaneously, the patient should be referred to a urologist for active stone removal.
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