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The kidneys maintain our body's balance of water, salts and minerals by filtering unwanted substances from the blood in the form of urine. If the substances become too concentrated, crystals form. These crystals attach to one another and collectively make a stone. Up to one out of every 11 adults in the United States will experience a kidney stone.
While a common problem, there is no one-size-fits all treatment: your best option depends on a variety of factors, including the size and location of the stone and related health factors. Kidney stones can be as small as a grain of sand but, if left untreated, can grow large - leading to the need for more complex surgical treatment.
Einstein offers a broad array of treatment options for kidney stone management, as well as coordination with other specialists when needed.
Our Comprehensive Kidney Stone Center is led by Justin Friedlander, MD. Dr. Friedlander is one of the area's top kidney stone doctors, also known as endourologist. His advanced training enables him to reduce the number of procedures for the most complex cases, resulting in shorter hospital stays for many patients.
Shockwave lithotripsy (SWL). The most minimally invasive option, this non-surgical method uses high-energy shock waves to break stones into very small fragments which are passed through urine. Not all stones can be treated this way; for example, SWL will not dissipate stones that are large, very dense or difficultly located. It also cannot be used on pregnant women or patients taking blood thinning medications.Ureteroscopy and laser lithotripsy. A small telescope is inserted through the urinary pathway with a laser, which breaks up the stone(s) in the ureter or kidney. This minimally invasive technique that requires no incision is a good option for many. Unlike shockwave lithotripsy, it involves extracting fragments to ensure the stone has been removed. Large stones may require multiple treatments to remove. This procedure may be performed on those taking blood thinning medications.Percutaneous Nephrolithotomy. Used for stones that are large, very firm or resistant to other kinds of treatment, this procedure involves using X-ray guidance to make a small, 1 centimeter incision through which a wire and a balloon are inserted to access the kidney. A small telescope is passed through the tube while a device called a lithotripter breaks up the stone. Your doctor will remove the stones through a catheter.
Patients require a short hospital stay; however, the stay is shorter than for "open" surgeries requiring larger incisions. Percutaneous nephrolithotomy claims greater success rates for clearing stones larger than 2 centimeters in one procedure. By comparison, shockwave lithotripsy and ureteroscopy often require several attempts.
Dedicated medical management. Patients at high risk of experiencing future kidney stones will receive a complete metabolic examination, including blood and urine sample tests. You and your doctor will discuss your diet, lifestyle, current medication(s) and other conditions that may affect your risk of forming stones and develop a plan to prevent them. This plan often includes dietary and lifestyle changes and medication if appropriate.
Your progress will be monitored with periodic urine tests and imaging studies that detect new stone growth. Working together, our goal is to help you work to prevent future surgeries and trips to the emergency room.
Cystinuria is a complicated type of stone disease caused by a defective gene. We offer complete care and treatment for patients with cystinuria and orther rare conditions that put patients at greater risk of forming kidney stones.
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