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Urinary Stone Disease - Treatment for Urinary (Kidney) Stones

Our Approach to Urinary (Kidney) Stone Disease

Treatment approaches for kidney stones depend on their size and whether they are causing pain or obstructing the urinary tract. Small stones (less than 4 millimeters) can sit in the kidney for months or even years without causing any pain or damage. Doctors may decide not to treat these stones. Once stones grow larger than 4 millimeters doctors usually treat them even if they are not painful, as these stones can move into the ureter and block the flow of urine, causing severe pain. Some large kidney stones, called staghorn stones, are painless but very dangerous because they can silently cause kidney failure.

Most stones less than 4 millimeters in diameter pass out of the body on their own. Some stones larger than this can be eliminated without surgery with one of the recently developed minimally invasive treatments. Doctors at Columbia University Department of Urology at New York-Presbyterian Hospital treat patients with urinary stones at our comprehensive, state-of-the-art facility. We use an all-inclusive medical, surgical, nutritional, and preventative approach to treat urinary stone disease along with the latest technological treatment advances.

Extracorporeal Shock Wave Lithotripsy (ESWL) for Urinary (Kidney) Stone Disease

Extracorporeal shock wave lithotripsy (ESWL) is a completely non-invasive treatment during which doctors focus shock waves from outside the body on the kidney stone. These waves break most stones less than three-quarters of an inch across into tiny fragments. The particles easily pass out of the body in the urine. ESWL can be performed with minimal anesthesia on an outpatient basis.

Ureteroscopic Laser Lithotripsy for Urinary (Kidney) Stone Disease

Some stones cannot be treated with ESWL because of their size, location, composition, or coexisting medical conditions. In most cases doctors can manage these using a minimally invasive technique called ureteroscopic laser lithotripsy. Doctors pass a tiny fiberoptic camera into the urinary tract through the urethra to the location of the stones in the bladder, kidney or ureter. Doctors at Columbia Urology then use a state-of-the-art device, the Holmium-YAG laser, to fragment and vaporize the stone into thousands of miniscule pieces, which are then flushed out of the body. Following this outpatient procedure patients recover very quickly and can return to normal activities within hours to days.

Percutaneous Lithotripsy for Urinary (Kidney) Stone Disease

To treat very large stones or those that can't be treated with other methods doctors at Columbia Urology may use percutaneous lithotripsy (percutaneous nephrolithotomy). In this procedure we make a tiny (one centimeter) incision in the flank and pass a camera through it into the kidney. We can then fragment the stones using ultrasonic or laser lithotripsy. Our doctors perform more of these operations than do surgeons at any other medical center in the U.S.

In fewer than 5% of cases, Columbia Urology surgeons must operate through a larger incision to remove kidney stones.

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