Using X-ray or ultrasound imaging to identify the stone, shockwaves are applied from outside the body to break the stone into smaller fragments that are then passed in the urine. Shockwave lithotripsy (SWL) is the least invasive procedure and is done on an outpatient basis. Our endourology team performs over a thousand of these procedures every year, using the latest technology. The most common techniques include shock wave lithotripsy, ureteroscopy with laser lithotripsy, and percutaneous nephrolithotomy. The procedures used today to remove stones are minimally invasive and highly effective. Surgical treatment is usually recommended for stones 0.5 centimeters in size and larger, as well as for patients who fail conservative management. The larger a stone is, the less likely that it will pass without surgery. Minimally Invasive Surgical Treatments for Kidney Stonesįactors that influence stone passage include the stone’s size and location. Many stones will pass with this management, without requiring a surgical procedure. Conservative management includes pain control (usually with acetaminophen and a non-steroidal anti-inflammatory drug like ibuprofen), hydration (6 to 8 glasses of water a day), and medical expulsive therapy using an alpha blocker (e.g., tamsulosin). We do this because many smaller stones will pass on their own, allowing patients to avoid surgery. In cases when the stone has moved into the ureter, especially if the stone is small (less than 0.5 centimeters), we often recommend conservative management. Kidney, ureter and bladder (KUB) plain abdominal radiographĬT Scan showing left kidney stone CT scan showing right ureteral stone Conservative Management They help us determine the location of the stone, its size, the degree to which the stone may be causing an obstruction to urine flow, and what types of therapy would be appropriate for management. When suspected of having a kidney stone, we take a history, perform a physical, exam, and obtain radiological imaging. Studies may include a plain x-ray of the abdomen, a renal ultrasound, or a CT scan. We also try to identify factors that may be causing the stones, so we can keep current stones from getting larger and reduce the risk of developing future stones.
We work with patients in every stage of their condition, creating a personalized plan whether surgery is needed or not. Occasionally stones can remain lodged in the ureter or within the bladder. Many stones will pass down the ureter, into the bladder and then be voided with urine. Once stones enter into the ureter the can obstruct the drainage of urine which generally causes symptoms such as pain in the upper back (i.e., the flank) or lower abdomen, nausea, vomiting, and blood in the urine. They may cause problems there, or may not be noticed until they move into the ureter (the tube that connects the kidney to the urinary bladder). As their name implies, stones almost always start in the kidneys. Kidney stones are conglomerations of crystals that form when concentrations of minerals in the urine become very high. We aim to minimize the duration of the period from symptom onset to resolution of the problem, and to resolve the problem with minimally-invasive techniques that are individualized for your specific situation. We intend to evaluate you and then manage your problem quickly, efficiently and effectively. Our urologists are experts in diagnostic evaluation, surgical therapies, metabolic studies and nonsurgical care, and treat approximately 1000 stone patients a year. As a comprehensive stone program we provide patient services across the entire spectrum of care – working closely with endocrinologists, nephrologists and radiologists to offer the best care possible to you.