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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 At New York Urology Specialists, we utilize advanced methods such as low-rate ESWL lithotripsy, advanced endourological techniques, stone size, location and Hounsfield units to optimize the treatment for kidney and ureteral stones.<\/p><\/blockquote>\n Kidney stones can be managed by lithotripsy (ESWL), flexible uretro-renoscopy (URS) and laser removal, or percutaneous nephrolithotomy (PCNL).<\/p>\n Lithotripsy for kidney stones\u00a0<\/a>is a\u00a0procedure that is performed with mild-to-moderate sedation or general anesthesia. The patient is fully asleep and does not feel pain or remember anything.<\/p>\n A special\u00a0machine that can break kidney and ureteral stones from outside the body is used. Lithotripsy is recommended for stones <20 mm (0.75 inches) in size. To break kidney and ureteral stones, focused shock waves (short pulses of high energy sound waves) are transmitted to the stone through the skin. The stone absorbs energy of the shock waves and fragments into smaller pieces. Stone fragments then pass with urine.<\/p>\n Contraindications to lithotripsy are pregnancy; women of childbearing age can have lithotripsy of kidney stones and upper ureteral stones but not lower ureteral stones. \u00a0Patients cannot take blood thinners such as aspirin,\u00a0warfarin and clopidogrel for a week before and up to 2 weeks after the procedure.<\/p>\n Complications of lithotripsy are rare but can occur. ESWL is suitable for over 90% of patients with kidney stones less than 1-2 cm.\u00a0<\/b><\/p>\n Renal stones that do not respond to lithotripsy (ESWL), that are very hard or located in areas where ESWL does not work well can be treated by flexible ureteroscopy. Many men and women who have contraindication to ESWL or for whom ESWL is unlikely to work (such as morbid obesity) may do well with ureteroscopy. Ureteroscopy is also effective for larger stones.<\/p>\n Ureteroscopy\u00a0<\/b><\/a>is a procedure typically performed under general anesthesia (patient is asleep) or spinal anesthesia (patient is numb from chest\u00a0down).<\/p>\n An endoscope (small camera) is inserted through the urethra (pee-hole) without making an incision. The stone is then located, broken to pieces with Holmium laser and fragments can be\u00a0pulled out using a special \u201cbasket\u201d. There are two types of ureteroscopes: flexible ureteroscope is used for kidney and upper ureteral stones. Semirigid ureteroscope is used for lower ureteral stones.<\/p>\n During the procedure, holmium laser is used to break up the stones in the kidney, ureter or bladder through a small endoscopic camera. \u00a0A small scope (ureteroscope) is passed through the urethra into the bladder, and from there up into the ureter to reach stones in the ureter and the kidneys.<\/p>\n Once the stones are located, they are targeted with a laser that breaks the stone into smaller pieces, which are then extracted, or into tiny pieces of dust that wash out from\u00a0the kidney with normal urine flow. \u00a0Most commonly Holmium laser is used to break up kidney stones as well as ureteral stones.\u00a0Bladder stones can also be broken with holmium laser.<\/b><\/p>\n Percutaneous Nephrolithotomy (PCNL or PNL)\u00a0is most suitable for removal of\u00a0larger kidney stones (\u22651-2\u00a0cm or >1 inch) or stones that are difficult to reach and break using ESWL lithotripsy<\/a> or ureteroscopy<\/a>. \u00a0It is a surgical procedure that is performed under general or spinal anesthesia.<\/p>\n During PCL, a needle is passed into the kidney via a 1 cm incision in the back. A guide wire is passed through the needle into the kidney. The needle is then withdrawn with the guide wire still inside the kidney. A nephroscope (a camera with a light source for viewing the inside of the kidney) is then passed inside the kidney; kidney stones are identified, broken and removed. This procedure can take anywhere from 1-4 hours depending on the size of the stones and complexity.<\/p>\n Once a patient is rendered stone free, a full evaluation to elucidate reasons for stone formation is undertaken. The results of further testing allows our urologists to make specific recommendations to prevent recurrent kidney stone<\/a> formation.<\/p>\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>is a board-certified urologist. He treats men and women with kidney and ureteral stones. \u00a0He is\u00a0among the most experienced specialists <\/strong>when it comes to treatment of large kidney stones and ureteral stones. Dr. Shteynshlyuger has performed hundreds of ureteroscopy and lithotripsy procedures<\/strong> for large kidney stones, in addition to ESWL procedures.\u00a0 He is among a select number of urologists in the United States who performs PCNL for large kidney stones. \u00a0<\/strong><\/p>\n <\/p>\n","protected":false},"excerpt":{"rendered":" Minimally Invasive Surgical Treatment of Kidney Stones 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 Options for Treatment of Kidney Stones The choices for surgical management in general remain the same for all types of stone disease. Recommended options depends on […]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"open","ping_status":"open","template":"","meta":{"ngg_post_thumbnail":0,"footnotes":""},"class_list":["post-68","page","type-page","status-publish","hentry"],"yoast_head":"\n
\nOptions for Treatment of Kidney Stones<\/h2>\n
![\"Treatment](\"https:\/\/www.newyorkurologyspecialists.com\/kidney-stones\/wp-content\/uploads\/sites\/10\/2013\/12\/man-woman-shutterstock_61928983-300x219.jpg\")
The choices for surgical management in general remain the same for all types of stone disease. Recommended options depends on stone size, stone location in the kidney or the ureter, and on any symptoms and signs, particularly of obstruction.<\/p>\nExtracorporeal Shock Wave Lithotripsy (ESWL)<\/b><\/a><\/h2>\n
Who Should Not Have Lithotripsy<\/h2>\n
Ureteroscopy (URS)<\/a>\u00a0with Laser Lithotripsy<\/b><\/h2>\n
Holmium Laser for Kidney Stones and Stones in the Ureter<\/b><\/a><\/h2>\n
PNL (PCNL<\/a>)<\/b>: Percutaneous Nephrolithotomy<\/h3>\n
Follow Up After Surgical Treatment of Kidney Stones<\/strong><\/h3>\n
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