Editing Nephrolithiasis (section)

== Management ==

* Indications for inpatient management
** Inability to tolerate PO intake
** Uncontrollable pain
** Fever
* Discuss with urology
** Signs of UTI
** AKI
** Anuria
** Unyielding pain, nausea or vomiting
** Stone >10mm (outpatient?)
** Stone does not pass after 4 weeks (outpatient?)
* Firm indications for emergency surgery
** Suspected or confirmed infection
** Bilateral obstruction and AKI
** Unilateral obstruction with one functioning kidney
* Indications for elective surgery
** Stones >10mm
** Uncomplicated distal ureteric stones <=10mm that have not passed after 4 weeks
** Persistently symptomatic stones
** Pregnant patients in whom observation has failed
** Persistent kidney obstruction
** Recurrent UTI related to stones
* Expectant therapy (high likelihood of passing, no sign of infection)
** Analgaesia - paracetamol, NSAID. Opioids if NSAIDs insufficient or AKI.
** Alpha blocker if stone >5 and <=10mm (tamsulosin 0.4mg daily)
** Strain urine