The recent proliferation of various low-carbohydrate and high-protein diets may place you at higher risk for stone formation. A high-protein diet increases urinary levels of stone constituents (calcium, oxalate and uric acid) and facilitates an optimal environment for stone growth (low citrate and low pH). We caution our stone patients against such a diet and if they insist, we recommend hydration to sustain daily urine output of at least 3000 cc. We also consider empiric citrate supplements.

Medical management of distal ureteral stone has been shown to significantly increase the rate of spontaneous passage of distal small stones. We routinely offer appropriate patients this option after detailed discussion with regard to potential side effects. Metabolic evaluation continues to be underutilized in patients with recurrent, multiple or familial history of kidney stones. We aggressively screen such patients with 24-hour urine assays, and we work closely with our nephrology colleagues to medically manage these patients.

Our practice is well-suited to attend to patients with kidney stones; our flexible and open schedule allows for immediate appointments (same-day or within 24 hours). As experienced urologists, we treat all types of kidney stones.

We routinely see patients with acute kidney stone attacks on the same day. Our full-service CT scan department allows for immediate radiographic diagnosis and a treatment decision in a single office visit. We use leading-edge techniques to solve kidney stone problems safely and effectively, including:

• Extracorporeal shockwave lithotripsy – This safe and effective technique reduces kidney stone treatment to a 30-minute outpatient procedure under sedation.

• Metabolic and stone risk assessment – In recurrent stone formers 
and medical treatment for stone prevention.

• Ureteroscopy – We also remove kidney stones with ureteroscopy 
and percutaneous nephrolithotomy.