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Medical News and Perspectives
November 5, 1997

Assessment of Exception to Informed Consent

JAMA. 1997;278(17):1392-1393. doi:10.1001/jama.1997.03550170020008

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BECAUSE the great majority of ureteral stones pass on their own, observation, increased fluid intake, and pain medication when needed constitute the best way to treat most patients with ureteral calculi, recommends the American Urological Association.

New treatment guidelines for the care of patients with kidney stones, which were released in September at the association's North Central Section annual meeting in Monterey, Calif, recommend more aggressive intervention only for stones larger than 5 mm in diameter or for patients with excruciating pain, urinary obstruction, or infection related to the stone Approximately 5% of the US population will develop kidney stones during their lifetime. However, about 85% of those stones will be smaller than 5 mm and can pass on their own, said Glenn M. Preminger, MD, a professor in the Department of Urology at Duke University Medical Center, Durham, NC, and facilitator of the expert panel that developed the guidelines

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