From the Guidelines
A 5mm kidney stone has a 68% chance of passing on its own, according to the most recent and highest quality study available 1. To increase the likelihood of spontaneous passage, it is essential to stay hydrated by drinking 2-3 liters of water daily. Pain management is also crucial, and medications like ibuprofen (600-800mg every 6-8 hours) can help alleviate discomfort. In some cases, prescription medications such as alpha-receptor antagonists may be recommended to aid in stone passage, with a reported stone-passage rate of 81% (95% CI: 72% to 88%) 1. It is vital to monitor for warning signs like severe pain, fever, chills, or inability to urinate, which may indicate the need for immediate medical attention. If the stone does not pass within 4-6 weeks or symptoms worsen, further medical evaluation and potential intervention may be necessary. Some key points to consider include:
- Staying hydrated to increase urine flow
- Managing pain with medication
- Monitoring for warning signs that may require medical attention
- Potential use of prescription medications to aid in stone passage, as supported by studies like the one published in The Journal of Urology 1.
From the Research
Passing a 5mm Kidney Stone on Its Own
- A 5mm kidney stone can pass on its own, but the likelihood and time it takes vary depending on several factors, including stone size, location, and individual patient characteristics 2, 3.
- Studies have shown that:
- For stones 5mm in size, the spontaneous passage rate is around 65% within 20 weeks 3.
- The time to stone passage is highly variable, but on average, it can take up to 31 days for stones 2mm or less, 40 days for stones 2-4mm, and 39 days for stones 4-6mm to pass 2.
- Intervention may be required in 50% of ureteral calculi greater than 5mm 2.
- Factors that can influence stone passage include:
- Stone size and location: smaller stones and those located more distally in the ureter are more likely to pass spontaneously 2, 3.
- Patient age and medical history: younger patients and those with a history of stone surgery may be more likely to experience stone events, but stone size is not a significant factor 4.
- Medical expulsive therapy (MET) with drugs such as tamsulosin and nifedipine has been studied as a potential treatment to improve stone passage rates, but results have been mixed, and their effectiveness is still uncertain 5.