At Mount Sinai, personalized care of patients with kidney stones, from diagnosis and assessment to treatment and follow-up, is our guiding principle. We are highly skilled in minimally invasive techniques to fragment and remove kidney stones. Treatment may also consist of dietary changes, medications and/or surveillance. With kidney stone disease, management decisions are based upon the size and location of the stone as well as the diet, lifestyle, and medical profile of the patient.
According to the National Institutes for Health, kidney stones are one of the most common disorders of the urinary tract. For unknown reasons, their incidence has been increasing in recent decades. The majority of kidney stones are formed in men. Men most commonly experience their first kidney stone between the ages of 30 and 50 while for women the age of first occurrence is somewhat later. For both men and women, having one kidney stone may be a precursor to additional kidney stones.
Kidney stones are crystal masses that separate from the urine and may get stuck in the kidney, ureter (the tube going from kidney to bladder), bladder or urethra (the tube going from bladder to outside the body). They can range in size from as small as a grain of sand to as large as a lemon.
When kidney stones remain in the kidney, they are often painless. But once they start to travel, the pain can be intense. People with kidney stones often have abdominal or back pain that can either be sharp or dull in nature. Blood can appear in the urine, and nausea and vomiting can occur. When an infection is present, a high fever may result. It is important to see your doctor if you have any of these symptoms because not only can kidney stones cause intense pain, they can eventually lead to kidney failure and the need for dialysis.
Because stones are often the result of under-hydration, they are more prevalent in warmer climates (the reason why some southern locales are referred to as “stone belts”) and among people who do not take in sufficient liquids.
Kidney Stone Treatment at Mount Sinai
Michael Palese, MD, Director of Minimally Invasive Surgery at Mount Sinai, heads up the Mount Sinai Kidney Stone Disease Program. He and his team utilize a variety of procedures to remove kidney stones based on stone size and type, a patient’s unique health profile, and his or her preferences for intervention. Treatments may include:
Extracorporeal Shock Wave Lithrotripsy (ESWL) is a process of stone crushing in which a high-energy shock wave generated by a high-voltage energy source crushes the kidney stone into particles which are then passed in the urine. Mount Sinai established one of the first lithotripsy centers in New York City more than 15 years ago. Our center allows patients to receive the benefits of one of the most advanced shock wave machines available. This new generation of machines improves the quality of the image of the stone and decreases the amount of time required to treat it. Lithotripsy is a non-surgical procedure with minimized risks that allows most patients to be treated on an outpatient basis. If hospital stays are required, they are generally brief.
Surgery - Minimally invasive surgery techniques enable our surgeons to use instruments either through a tract which goes from the back into the kidney (percutaneous procedure), or through the urethra and bladder to the ureter and kidney (ureteroscopic procedure), to fragment the stone or remove it entirely. Because these surgical techniques are minimally invasive, there are potentially fewer risks and patients recuperate more quickly, resulting in shorter hospitals stays than ever before.
Laser procedures – These minimally invasive procedures incorporate laser lithotripsy and are used for kidney stone fragmentation. Advanced laser technology at Mount Sinai allows for the utilization of much smaller endoscopes. Therefore, most patients have laser procedures on an outpatient basis.
Follow-up Care - Approximately two-thirds of patients who have had one kidney stone are at risk for developing another kidney stone in the future. Because of this high rate of recurrence, we recommend a metabolic evaluation which includes stone analysis, blood, and urinary testing. Additional testing including the use of bone density measurements is sometimes required. This evaluation identifies the source of problems in more than 90 percent of patients and is invaluable for optimal management planning. Dietary changes (which vary from person to person) and/or medications can help to decrease future stone formation. Periodic evaluations with state-of-the-art non-invasive imaging can also be helpful.
We Can Help
If you have symptoms of kidney stones or have experienced stones in the past, Dr. Palese and his team will be happy to see you for treatment or consultation. Please call us at 212-241-4812.
Tel: 800-MD-Sinai (800-637-4624)
To make an appointment:
Following are dietary guidelines for the prevention and management of kidney stones. Your doctor will advise which guidelines are appropriate for you based upon the type of stones you have experienced.