{"id":3646,"date":"2016-08-30T05:55:40","date_gmt":"2016-08-30T05:55:40","guid":{"rendered":"https:\/\/www.newyorkurologyspecialists.com\/kidney-stones\/?page_id=3646"},"modified":"2016-08-30T05:57:45","modified_gmt":"2016-08-30T05:57:45","slug":"3mm-4mm","status":"publish","type":"page","link":"https:\/\/www.newyorkurologyspecialists.com\/kidney-stones\/treatment\/upj\/3mm-4mm\/","title":{"rendered":"Kidney Stones at UPJ: Treatment of 3 mm-4 mm stones"},"content":{"rendered":"

Treatment Options For 0.3 cm – 0.4 cm UPJ Stones: Experienced Urologists 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

Treatment of small 1-4 mm stones at UPJ (Ureteropelvic junction):<\/strong><\/h2>\n

\"UPJIt is fairly uncommon for stones smaller than 5 mm to block the UPJ but it does happen occasionally.\u00a0 Whenever stones smaller than 3mm-4mm block the UPJ, the patient needs to be evaluated whether he or she has an associated ureteral narrowing called \u201cUPJ obstruction\u201d.<\/p>\n

Small Stones at UPJ Can often Pass Spontaneously<\/strong><\/h2>\n

Smaller stones that are less than 3-5 mm in size have a better chance of passing spontaneously. Stones less than 2 mm rarely get stuck at UPJ.\u00a0 If imaging shows a 3-5 mm stone obstructing the junction of the kidney and the ureter, observation is a reasonable option. Often, small stones less than 5-6 mm will pass with conservative therapy.<\/p>\n

While some patients with small stones 2-3 mm in size, may experience slight discomfort or pain when the stone passes, many patients may remain completely unaware of the stone passing spontaneously and never seek care.<\/p>\n

When Surgical Treatment is Necessary for small UPJ Stones?<\/strong><\/h2>\n

If no infection is present,<\/strong> observation is a reasonable option and the patient may be able to pass the stone spontaneously. \u00a0As many as 60-85% of small stones at UPJ may be passed spontaneously.<\/p>\n

If infection is present<\/strong>, infection must first be treated urgently<\/u> before any procedure to break the stone can be performed. It may be necessary to place a stent in the ureter to keep it open while the infection is being treated.<\/p>\n

If kidney function is compromised<\/strong> by kidney stone, urgent treatment is necessary.<\/p>\n

If the patient is experiencing recurrent pain or has nausea and vomiting and cannot tolerate a diet, then an intervention is reasonable.\u00a0 The choice of treatment, shockwave lithotripsy, JJ stent insertion or one-step ureteroscopy with Holmium laser and JJ stent insertion is chosen based on patient parameters and preferences.<\/p>\n

If a patient has recurrent pain and the stone is not coming down on its own, it may be reasonable to do shock-wave therapy (ESWL). ESWL is the first choice of treatment for UPJ stones that are 4 mm \u2013 5 mm in diameter.\u00a0 <\/strong>Shockwave lithotripsy has fewer complications than ureteroscopy and has similar success rates up to 90% for small UPJ stones. Shockwave is a less invasive procedure than ureteroscopy.<\/p>\n

For some patients ESWL is not an option if the stone cannot be seen on X-rays or on ultrasound which is a common situation with small UPJ stones. In that case ureteroscopy is the procedure of choice.<\/p>\n

Ureteroscopy with Holmium laser lithotripsy<\/strong> is also an option. Although it has a little higher risk of side effects, the chances of breaking the stone completely are also greater. For a UPJ stone less than 5 mm in size, both ESWL and ureteroscopy with Holmium laser lithotripsy have good stone fragmentation rates. Following ureteroscopy, usually a ureteral stent is left behind for a few days to a week. <\/u><\/p>\n

Ureteroscopy Vs Shockwave Lithotripsy For Small UPJ Stones<\/u><\/h2>\n

The choice of treatment between ESWL and ureteroscopy depends on the patient’s characteristics<\/strong> as well. For example, obese patients are less likely to benefit from ESWL and may be better suited to ureteroscopy.<\/p>\n

Small stones at UPJ may be difficult to see on X-rays or ultrasound and shockwave lithotripsy may not be an option for this reason.<\/p>\n

Patient who take blood thinners are not good candidates for ESWL.<\/p>\n

Recovery<\/strong> is a little faster after ESWL which is less invasive compared to ureteroscopy. Most people are able to return to and regular activities in 1-2 days after either ESWL or ureteroscopy.<\/p>\n

After either shock-wave lithotripsy or ureteroscopy, patients might have some blood in the urine (pink urine) for a few days. Some soreness may be present at the site where ESWL is done or at the urethra for a few days after the ureteroscopy procedure.<\/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

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

Treatment Options For 0.3 cm – 0.4 cm UPJ Stones: Experienced Urologists 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 stones and ureteral […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":3641,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"ngg_post_thumbnail":0,"footnotes":""},"class_list":["post-3646","page","type-page","status-publish","hentry"],"yoast_head":"\nKidney Stones at UPJ: Treatment of 3 mm-4 mm stones - 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\/upj\/3mm-4mm\/\" \/>\n<meta name=\"twitter:label1\" content=\"Est. reading time\" \/>\n\t<meta name=\"twitter:data1\" content=\"4 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\/upj\/3mm-4mm\/\",\"url\":\"https:\/\/www.newyorkurologyspecialists.com\/kidney-stones\/treatment\/upj\/3mm-4mm\/\",\"name\":\"Kidney Stones at UPJ: Treatment of 3 mm-4 mm stones - 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