Question

A 63-year-old man presents with sudden severe left-sided flank pain radiating to the groin. He is writhing in pain, afebrile and haemodynamically stable. Urinalysis shows microscopic haematuria. A non-contrast CT KUB confirms a 4 mm distal ureteric stone with no hydronephrosis. What is the most appropriate management?

Accepted Answer

Discharge with oral NSAIDs, hydration advice and follow-up, as the stone is likely to pass spontaneously

Answer

Admit for emergency ureteroscopic stone removal

Answer

Start long-term allopurinol immediately

Answer

Insert a nephrostomy tube urgently

Answer

Start broad-spectrum intravenous antibiotics

Practice question