I wouldn't say that five stringers are standard. I think it's very common, at least in Swedish orchestras, to play standard four-stringers (although most have a C-extension these days) and maybe have some fivers thrown in in lack of more extendeds, for good measure, or because some things are simply easier to play on a fiver. A problem for all individuals and most orchestras is that a fiver equivalent to a good 4 is a lot more expensive, this probably being a result of the general problems that comes with a high pressure, and the bigger overall size. A 5er that feels and plays like a 4-string is simply rare. We have a 70's Pöllmann 5-string at school which is now poorly set up by some luthier who obviously was better with violins; it's huge, it makes you hurt, but I still think it'd sell at a rather high price. The value of a brand new five stringer therefore usually better matches the invested amount than a 4-string.
A Rubner 5-string I played once was unusually good (both for being a Rubner and being a hi low-to-mid class bass) but its bass bar was too weak, and the top was sagging in a way which seemed to imply that it would be around much longer.
I believe many people with high end basses, who wants to be able to use them also for the pieces that requires a fifth string, prefer to put on an extension over having it converted to 5 strings. The small hole drilled in the scroll is less molesting to the bass and its history than having it converted properly, plus, many players have expressed gratification of the way their basses seems to have "opened up" with the extended E, while an added B-string is unlikely to improve the tonal qualities, even on basses that were absolute high end from the beginning.
Arnold is completely right that the required arch of the bridge and FB may surprise anyone. Ergonomical issues, and problems with hitting the top or corners with the bow, may arise as the G gets far away from you. I usually like playing them, though, as long as they are decently set up.
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