The Hudson Valley's
Premiere Urology Specialists

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Stone Center

Kidney Stones

Also called: Nephrolithiasis

A kidney stone is a solid piece of material that forms in the kidney from substances in the urine. It may be as small as a grain of sand or as large as a pearl. Most kidney stones pass out of the body without help from a doctor. But sometimes a stone will not go away. It may get stuck in the urinary tract, block the flow of urine and cause great pain.

kidney The following may be signs of kidney stones that need a doctor's help:
  • Extreme pain in your back or side that will not go away
  • Blood in your urine
  • Fever and chills
  • Vomiting
  • Urine that smells bad or looks cloudy
  • A burning feeling when you urinate

Click here for a self-help tutorial from the National Library of Medicine.

Extracorporeal Shock Wave Lithotripsy (ESWL)

eswl

The Urology Center of Westchester is a leader in this non-invasive method of treating kidney stones. 'Extracorporeal' means 'outside the body': ESWL is a method to treat kidney stones from outside the body. ESWL is a non-surgical treatment which can dissolve kidney stones to allow them to pass naturally. We are allied with the Hudson Valley Lithotripsy Center which was the first ESWL treatment center in Westchester and its surrounding 5 counties. Our lithotripsy unit is a modern, convenient, and caring center of excellence. Our staff has a combined 20 years of experience in treating a wide variety of kidney, ureteral, and orthopedic stones. ESWL requires light sedative anesthesia and patients are typically discharged home from the office. Our physicians will discuss your case with you in detail and determine whether one session of ESWL is sufficient to get rid of the stones or if two sessions may be required with any additional procedures. Prior to consulting with our ESWL physicians, please make sure you bring with you any:

  • medical records
  • copy of a recent CT scan
  • copy of a recent plain X-ray of the abdomen
  • any surgical records
  • name and fax number of your PCP

Ureteroscopy

In many cases, "ureteroscopy" is required to treat a stone of the kidney or ureter. Ureteroscopy is an endoscopic procedure which allows a small < 5mm camera to be inserted into the ureter and often all the way up to the kidney. In cases of stone treatments, a laser fiber just 2-3 millimeters wide is then passed through the ureteroscope to allow the urologist to apply laser energy to vaporize the stone. We have more than 25 years of experience and expertise in ureteroscopy.

Some bullet points about ureteroscopy:
  • General Anesthesia required though in some cases spinal anesthesia is adequate
  • Procedure takes about 1 hour
  • Often requires a internal stent to be temporarily left inside for a few days
  • Medical clearanc for general anesthesia required before surgery
  • Patients must stop anticoagulants and/or aspirin when told to do so

Percutaneous Nephrolithotripsy (PCNL)

In some cases, when a kidney stone is large, like a staghorn kidney stone, your urologist may get to it directly but putting a 1 centimeter-wide tube into the kidney. The tube then allows powerful lasers or ultrasonic lithotripters to break up the stone and remove the fragments. The procedure requires a 1 cm incision in the flank under general anesthesia. The procedure, known as a PCNL or 'perc', has completely replaced the old fashioned surgery to remove kidney stones which often required a 12 inch cut directly through the side. PCNL patients often go home the next day, sometimes the same day. Our urologists helped develop the field of PCNL in the mid 1980s, a 30 year experience that we carry on to this day in terms of complexity of cases, training, and education.

Some bullet points about PCNL:

  • General Anesthesia required
  • Procedure takes about 1-4 hours depending on the number and size of stone(s)
  • Often requires a tube to be temporarily left draining the kidney for a few days
  • Medical clearanc for general anesthesia required before surgery
  • Patients must stop anticoagulants and/or aspirin when told to do so