Kidney Stone Care

Kidney Stone Care Focused on Medical Treatment and Prevention

Kidney stones can cause sudden, severe pain and disrupt daily life — but sometimes they are found by accident during imaging done for another reason, with no symptoms at all.

At Lahey Clinic, the Departments of Urology and Nephrology work together to provide kidney stone care focused on accurate diagnosis, effective treatment, and long-term prevention. Care is personalized based on the type of stone, your symptoms, and your overall kidney health.

Urologists lead the treatment of kidney stones. They are trained in both medical and surgical care and can remove or manage stones using a range of treatment options. After the stone has been treated, both your urologist and a nephrologist (a kidney specialist) can help lower your chances of getting more stones. They can run follow-up tests, identify what is causing your stones, and recommend lifestyle changes or medications to help prevent future ones.

Your care team works together to manage pain, clear stones, and build a plan to keep you as healthy as possible going forward.

Understanding Kidney Stones

Kidney stones form from high levels of minerals and salts in the urine. These substances can harden to form crystals in the kidneys. Several factors can increase risk, including dehydration, diet, certain medical conditions and family history.

Some stones pass on their own, while others require treatment. Knowing when to see a doctor for kidney stones can help prevent complications, such as infection or kidney damage.

Kidney Stone Treatments

Led by Jessica Mandeville, MD, the Kidney Stone Center is dedicated to the evaluation and treatment of patients with all types of kidney stone disease, specializing in patients with:

• Kidney and ureteral stone disease, including complex staghorn stones and stone disease in patients with complex genitourinary anatomy, such as patients with prior kidney or ureteral surgery or those with prior bladder replacement surgery
• Metabolic kidney stone diseases, including rare conditions that cause severe kidney stone disease such as cystinuria, hyperoxalurias (including hyperoxaluria due to bowel disease), renal tubular acidosis, hyperparathyroidism, sarcoidosis, idiopathic hypercalciuria, and uric acid stones/hyperuricosuria

When it comes to surgical treatment, the options offered depend on the size, type, and location of the stone, as well as your symptoms. Most treatments are minimally invasive, meaning less cutting and faster recovery.

Treatment options may include:

• Medication to help the stone pass on its own, manage pain, or relax the urinary tract
• Shock wave therapy (ESWL), which uses sound waves from outside the body to break stones into smaller pieces that are easier to pass
• Ureteroscopy with laser lithotripsy, a procedure where a thin camera is passed through the urinary tract to find the stone, and a laser is used to break it apart
• Percutaneous nephrolithotomy (PCNL), a minimally invasive procedure that removes larger stones directly from the kidney through a small incision in the back
• Robotic stone extraction for complex cases where robotic tools offer greater precision and control
• Open surgery when other treatments are not effective

Your care team will help find the best option for you based on your specific situation.

How Are Kidney Stones Diagnosed?

Diagnosis often begins with a review of symptoms and medical history, followed by testing.

A test for kidney stones may include:

• Urine and blood tests
• Imaging studies such as CT scan, X-ray or ultrasound

These tests support an accurate kidney stone diagnosis and help guide treatment decisions.

Expert Care from Kidney Stone Specialists

Kidney stones are primarily treated by urologists, doctors who specialize in the urinary tract and are trained in both medical and surgical care. Your urologist will lead your treatment and help remove or manage your stone.

Once the stone has passed or been removed, both your urologist and a nephrologist (a kidney specialist) can help lower your risk of getting more stones. Either provider can order follow-up testing, look at what may be causing your stones, and recommend lifestyle changes or medications to help prevent future ones.

Together, your care team will create a plan that is right for you.

Preventing Kidney Stones

Kidney stone prevention focuses on reducing the chance of stones forming again. Prevention plans are tailored to stone type and personal risk factors.

Support may include:

• Nutrition guidance, including hydration and dietary changes
• Medication review and prevention strategies
• Ongoing monitoring of kidney health