Kidney Stone Treatments
Mantu Gupta, MD, is Director of the Kidney Stone Center at Mount Sinai. In addition to monitoring and prescribing medications to aid in the expulsion or dissolution of small stones, he and his team utilize a variety of noninvasive and minimally invasive procedures to remove kidney stones based on the size and type, a patient's unique health profile, and his or her preferences for intervention. Dr. Gupta also employs a nutritional, holistic and preventive approach to the management of stone disease to ensure comprehensive and personalized care.
Treatment for Small Kidney Stones
Not all kidney stones need surgical treatment. Stones that are small and are possibly able to pass spontaneously can be safely observed in the absence of severe pain, nausea, vomiting, swelling of the kidney (known as hydronephrosis), or infection. If a small stone is in the ureter, medical therapy with an alpha antagonist has been shown to speed the passage of the stone and also decrease the amount of pain and the need for narcotic analgesics, and our own research supports this.
Small, asymptomatic stones in the kidney can also usually be safely observed, if they are deemed to be passable. Medical evaluation can identify individual factors that can be addressed by dietary changes, the use of vitamins or supplements, or, if necessary, medications that will prevent stone growth or can result in stone dissolution.
Percutaneous Nephrolithotomy (PCNL)
In addition of lithotripsy, percutaneous nephrolithotomy (PCNL) is a minimally invasive technique for the removal of large kidney stones. A small keyhole opening is made in the patient’s side and a sheath is placed into the kidney. A camera placed through the sheath visualizes the stones, and they are fragmented using a pneumatic or ultrasound device and then removed. Dr. Gupta is renowned for this type of surgery and has taught this procedure to other urologists throughout the world for almost 20 years. He has pioneered less invasive techniques of PCNL, including a new procedure in which the opening that is made is only eight mm (less than 1/3 of an inch), resulting in less pain and quicker recovery without changing the success rate.
Our Multidisciplinary Approach
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, Mount Sinai physicians 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 supplements and vitamins can also help to decrease future stone formation. Our physicians have tremendous experience in the evaluation of risk factors of stone disease and the nonsurgical treatment of kidney stones.
Our Kidney Stone Center prides itself in its holistic approach to the kidney stone patient. This involves consultation with a nephrologist experienced in the causes and prevention of kidney stone disease, a dietitian who can provide a detailed evaluation of a patient’s nutritional needs and can create a personalized plan that will help prevent kidney stones while maintaining a balanced and heart-healthy diet, an alternative medicine specialist who can help find alternatives to medicines and invasive procedures, and an endocrinologist who can evaluate bone health, especially in women at risk for osteopenia and osteoporosis. Our team also performs periodic evaluation with state-of-the-art non-invasive imaging to monitor kidney stones that do not need removal and to observe for new stone formation, since early detection can avert a painful kidney stone attack.
Tel: 800-MD-Sinai (800-637-4624)
To make an appointment:
Dr. Mantu Gupta 212-241-1272
Dr. Michael Palese 212-241-4812
Dr. Courtney Phillips 212-241-4812
Mantu Gupta, MD, Director of Mount Sinai's Kidney Stone Center, discusses the increased risk for kidney stones during the summer. Watch this video