Kidney Stone Disease
In the United States, urinary stones form most frequently within the kidney, and are the result of abnormal salts deposited as crystals. Urinary stone formation may be influenced by a number of factors, many of which are identifiable and potentially preventable. The urologist will often perform serum and urinary measurements to identify predisposing factors in stone forming patients in an attemot to prevent future episodes. This evaluation will often follow initial management of the acute stone episode.

Common kidney stone symptoms are flank pain, blood in the urine, and sometimes fever. Treatment for acute episodes include hydration and pain control, and treatment of any associated infection. Stone size and location will often guide the most appropriate intervention. Often observation in anticipation of spontaneous passage is indicated. Some patients will require more immediate intervention, and my receive some type of treatment to break-up the stone. Modern therapies for stone fragmentation include shock wave lithotripsy (i.e., external shock waves) and laser lithotripsy.

Shock Wave Lithotripsy
Shock wave lithotripsy uses x-ray or ultrasound imaging to concentrate high energy pressure waves on kidney stones, reducing them to sand-like particles. This procedure can often be performed with sedation only without the need for general anesthesia. Most patients return home shortly following the procedure after a period of observation.

Laser Lithotripsy
Laser lithotripsy involves treating all types of stones using small, minimally invasive telescopes called endoscopes. These fiber-optic endoscopes allow the application of high energy lasers to stones located virtually anywhere in the urinary tract.

Medical Dissolution
Some urinary stones may dissolve by altering the urinary pH level. This approach will be considered most commonly in patients with uric acid stones in the setting of acidic urine. Oral agents that raise the urinary pH may dissolve uric acid stones and avoid further intervention.