More About Kidney Stones

What are kidney stones?

Kidney stones are formed when minerals such as calcium crystallize in the urine. The stones typically form in the kidneys and can cause pain or urinary blockage when they pass.

The UT Health San Antonio Comprehensive Kidney Stone Center is unique because we provide care for the entire disease process from acute stone treatment with state-of-the-art procedures to comprehensive metabolic evaluation for the prevention of stone recurrence.

Treatments

Minor outpatient procedures such as cystoscopy with ureteral stent placement to bypass an obstructing kidney stone may be performed in the office. Outpatient surgery, if needed, may be performed by our physicians at the MARC Day Surgery Center. More complex percutaneous procedures requiring overnight observation will be performed in a hospital.

Our board-certified, fellowship-trained endourologist's specialize in treating kidney stones and offer a range of minimally invasive surgical options including:

• Extracorporeal shock wave lithotripsy (ESWL), a non-invasive procedure in which sound waves are sent through the back and focused onto a kidney stone. The sound waves create a shock wave that causes the kidney stone to fragment. The ideal patient for shock wave lithotripsy is someone with a small stone (less than two centimeters in diameter) in the kidney or the ureter that is not causing significant obstruction. The procedure is an outpatient procedure done under sedation or general anesthesia. Patients will usually go home the same day the procedure is done.
• Ureteroscopy, a minimally-invasive procedure in which a small scope is placed through the urethra into the bladder and up the ureter to a kidney stone. The kidney stone is then fragmented with a laser and/or extracted with a small basket. At the end of the procedure, a temporary stent is placed in the ureter to prevent blockage of urine flow due to the passage of stone fragments or swelling of the ureter. The ideal patient for ureteroscopy is someone with a small stone (< 2 cm in diameter) or a small collection of stones in the kidneys or the ureters. The procedure is an outpatient procedure done under general anesthesia. Patients will usually go home the same day the procedure is done.
• Percutaneous nephrolithotomy, a minimally-invasive procedure in which a small scope is placed through the back into the kidney. The kidney stones are then broken up with a combination ultrasound and pneumatic probe or laser and extracted through the back. At the end of the procedure, a drainage tube (nephrostomy) is left in the kidney to drain the kidney in case blockage of urine flow due to stone fragments, blood clot, or swelling of the ureter occurs. The ideal patient for percutaneous nephrolithotomy is someone with a large stone (greater than two centimeters in diameter) for which shock wave lithotripsy and ureteroscopy have low treatment success rates. The procedure is considered an outpatient procedure but patients are observed overnight. The procedure is done under general anesthesia.

Prevention

For patients at increased risk for kidney stone recurrence and who wish to pursue a proactive approach to preventing future stones, we provide a comprehensive metabolic evaluation. This evaluation helps determine the causes of a patient’s kidney stones and directs preventative strategies that may involve focused dietary changes or medication therapy.