<s>[INST] My husband has been suffering from a 4mm kidney stone for 5 days.  We have had two trips to the ER for s total of 20 hours.  He is in severe pain most of the time, even with prescribed pain killers.  He just started peeing black specs.  Does thismean the stone is close to passing?  At what point do we demand it be surgically removed?  He has barely eaten in 5 days and is very week.  He can't work and is miserable.  He us drinking LOTS! [/INST] Hi, it appears that the kidney stone has come near to the urethral opening. As it is a stone of 4 mm, only it may come out automatically. Hi may need to have analgesics for controle of pain, then he wont have the contractin of urethra and there is possibility of the expulsion. so i advise you to consult a urologist for diagnosis and treatment. Surgery may not be necessory. Thank you. </s>