Stone Management

Stone disease, or nephrolithiasis, is a part of life in the South, and particularly Eastern North Carolina. It is slightly more prevalent in males compared to females, and is also seen in children. It accounts for about 1% of hospital admissions. Unfortunately, without treatment, most first-time stone formers will recur within 1-5 years. Your Urologist at Eastern Urological Associates has options for the conservative and medical treatment of stone disease in order to decrease recurrent stone forming episodes.

Humans are always on the brink of stone formation. Inadequate hydration, urinary tract obstruction, or the development of other medical problems may push these patients toward stone formation. The incidence of stone disease is on the rise due to poor diet, increasing complexity of other medical problems, and the epidemic of obesity in North Carolina. This region is also a high-risk area due to dehydration from the warm climate and the high volume of gastric bypass surgeries performed, which predisposes patients to stone formation.

Stones seen in our are include calcium stones, uric acid, infection or struvite stones, and the rare cysteine stone. It is important to determine the type of stones being formed and to look for the metabolic disorder and/or anatomical problem predisposing one to stone formation. Common metabolic problems are dehydration, gastrointestinal malabsorption, high uric acid levels, and disorders of calcium metabolism. Depending on your type of stones, we or another physician may recommend diet changes; for more information on this, please refer to these documents

Clinical presentations of nephrolithiasis range from asymptomatic to the critically ill, septic patient. Most patients, however, present with pain. Nausea, vomiting, bloody urine (hematuria),  and fever are also common presenting complaints. Stone pain, or kidney colic, is typically episodic, severe, not relieved by over the counter analgesics, and not exacerbated by activity or positional changes.

Some stones are passable without intervention - only a specialist can determine whether this is true for a particular patient. Eastern Urological Associates (EUA) uses a thorough medical history, physical exam, and imaging to diagnose and manage nephrolithiasis. Our office has seven providers, a Phillips digital X-ray on site, as well as on site GE ultrasound and Nuisys multi slice CT scanner. EUA is a partner with Carolina Lithotripsy and uses Siemens shockwave lithotripsy technology to pulverize stones in a minimally invasive fashion.  At Vidant Surgicenter and Vidant Medical Center all the latest technology is available including endoscopy equipment and laser technology for stones that require an operation. Our Urologists are experts in upper tract endoscopy and percutaneous approaches for the treatment of larger stones. They also assist their stone patients with lifestyle, diet modification, and other methods of conservative stone prevention.