{"id":3626,"date":"2016-08-30T04:34:05","date_gmt":"2016-08-30T04:34:05","guid":{"rendered":"https:\/\/www.newyorkurologyspecialists.com\/kidney-stones\/?page_id=3626"},"modified":"2016-08-30T04:38:53","modified_gmt":"2016-08-30T04:38:53","slug":"4-mm-5-mm","status":"publish","type":"page","link":"https:\/\/www.newyorkurologyspecialists.com\/kidney-stones\/treatment\/uvj\/4-mm-5-mm\/","title":{"rendered":"4 mm-5 mm at UVJ and Distal Ureter Stone Treatment in NYC"},"content":{"rendered":"

Small Stones at the UVJ: Treatment of 0.3 cm to 0.5 cm and Smaller Stones in NYC<\/strong><\/h1>\n

by Alex Shteynshlyuger MD<\/a><\/strong><\/p>\n

\n

If you have any questions, to\u00a0schedule a consultation<\/a>\u00a0or if you need a second opinion<\/a>, please\u00a0<\/a>contact us<\/a>\u00a0or call: 646-663-4421<\/a><\/strong><\/p>\n

Dr. Alex Shteynshlyuger<\/a>\u00a0<\/a>\u00a0is a board certified urologist in NYC who\u00a0specializes in treating\u00a0men and women with kidney stones and ureteral stones.<\/b><\/p>\n

\n

3\u00a0mm -5 mm UVJ Stone Treatment<\/strong><\/h2>\n

\"UVJStones that are less than 5 mm in size at UVJ have a good chance to pass spontaneously. In fact, as many as 90% of 1-5 mm UVJ stones can be passed with medical expulsion therapy<\/strong> (MET) by drinking fluids, taking pain medications and medications such as Flomax.<\/p>\n

If CT scan reveals that a small stone is blocking the ureterovesical junction (UVJ), observation and trying to pass the stone spontaneously is a reasonable option, as long as there are no signs of infection and kidney function is normal. <\/u><\/p>\n

It is rare for 1 mm or 2 mm stones to block the UVJ<\/strong> but it can happen occasionally and some of these patients require surgical treatment.\u00a0 Most stones that are 0.1cm to 0.3 cm are passed without the patient being aware of it.<\/p>\n

Stones that are 0.4 cm to 0.5 cm at UVJ are more commonly seen in the ER with symptoms of kidney stone pain.<\/p>\n

For small UVJ stones in healthy patients<\/strong>, urologists at New York Urology Specialists will typically allow a patient to wait for 30 days before recommending surgical intervention as long as the pain is manageable, there is no severe nausea or vomiting and there is no infection.<\/p>\n

In patients with poor kidney function<\/strong> or only one functioning kidney,<\/strong> the risk of kidney failure due to obstruction is high. In these patients, MET may be attempted for some patients for a 1-5 mm UVJ stone, but this must be done under close monitoring by a physician.<\/p>\n

If a small stone is stuck and creates blockage at UVJ (the junction of the ureter and the bladder), and the patient has symptoms of severe pain<\/strong>, nausea<\/strong> and vomiting<\/strong>, or signs of infection<\/strong> (fever, chills, UTI), then surgical<\/u> treatment needs to be instituted immediately<\/u>.<\/p>\n

It should be noted that procedures such as ESWL or ureteroscopy are not performed in the presence of an active infection<\/u>. The infection must be treated before the stone can be broken up or removed.<\/strong><\/p>\n

When signs of infection are present or the ureter is too narrow to look inside the ureter, the preferred treatment option for a 1-5 mm UVJ stone is JJ stent insertion <\/u><\/strong>to keep the ureter patent (open), followed by removal of the stone at a later date once the infection has cleared.<\/p>\n

Other treatment options for 1-5 mm stones at the UVJ junction include ESWL and ureteroscopy with Holmium laser lithotripsy. These can only be performed if there is no infection.<\/p>\n

Ureteroscopy is a slightly more invasive procedure, but it is also more effective in rendering patients stone-free.<\/p>\n

\n

If you have any questions, to\u00a0schedule a consultation<\/a>\u00a0for treatment of kidney stones\u00a0or if you need a second opinion<\/a>, please\u00a0<\/a>contact us<\/a>\u00a0or call: 646-663-4421<\/a><\/strong><\/p>\n

Dr. Alex Shteynshlyuger<\/a>\u00a0<\/a>\u00a0is a board certified urologist in NYC who\u00a0specializes in treating\u00a0men and women with kidney stones and ureteral stones. \u00a0He has treated hundreds of men and women with large kidney stones.<\/b><\/p>\n

 <\/p>\n

\n","protected":false},"excerpt":{"rendered":"

Small Stones at the UVJ: Treatment of 0.3 cm to 0.5 cm and Smaller Stones in NYC by Alex Shteynshlyuger MD If you have any questions, to\u00a0schedule a consultation\u00a0or if you need a second opinion, please\u00a0contact us\u00a0or call: 646-663-4421 Dr. Alex Shteynshlyuger\u00a0\u00a0is a board certified urologist in NYC who\u00a0specializes in treating\u00a0men and women with kidney […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":3620,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"ngg_post_thumbnail":0,"footnotes":""},"class_list":["post-3626","page","type-page","status-publish","hentry"],"yoast_head":"\n4 mm-5 mm at UVJ and Distal Ureter Stone Treatment in NYC - NYC Kidney Stone Clinic<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.newyorkurologyspecialists.com\/kidney-stones\/treatment\/uvj\/4-mm-5-mm\/\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"3 minutes\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\/\/schema.org\",\"@graph\":[{\"@type\":\"WebPage\",\"@id\":\"https:\/\/www.newyorkurologyspecialists.com\/kidney-stones\/treatment\/uvj\/4-mm-5-mm\/\",\"url\":\"https:\/\/www.newyorkurologyspecialists.com\/kidney-stones\/treatment\/uvj\/4-mm-5-mm\/\",\"name\":\"4 mm-5 mm at UVJ and Distal Ureter Stone Treatment in NYC - 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