Once a patient has been diagnosed with a kidney stone, there is a process to be followed to determine what treatment is best. If a doctor feels that surgical treatment is necessary they will refer you to the Kidney Stone Center. Your doctor or you will be asked to send medical history, physical exam results, imaging studies, insurance information and patient information to the Kidney Stone Center. The Center then reviews the medical information, verifies the insurance coverage, and the urologists at the Center review the case and make a recommendation as to the best treatment. We do have a procedure for handling cases where there is no insurance coverage.
There is a mandatory second opinion to verify the proposed treatment. If the case is to be treated at the Center, the case is then scheduled with the patient and referring doctor's office. Once scheduled, the patient will receive specific instructions as to diet, when to stop eating and drinking, and what medications to take and what not to take. (See the restricted Medication list) The patient will be told when to appear at the Center for treatment. If these instructions are not followed, the case may be cancelled. You and your referring urologist are also told what laboratory tests are necessary before treatment. Depending upon your medical condition the tests required may be minimal or extensive and may include blood tests, urine tests, x-rays, and cardiograms.
The patient is asked to arrive at their scheduled time. After arrival, you can expect to wait before your procedure begins depending upon conditions and your needs. You should arrive at the Center accompanied by a responsible adult. You will be prepared for surgery, an IV will be started and informed consents are done by the anesthesiologist, treating urologist and nurse. Post operative instructions are given. Each treatment takes an average of 1 to 1 1/2 hours. The patient must recover from the procedure in the recovery room before discharge. Total time at the Center is usually 4-5 hours. The patient must arrange to have a responsible adult transport them at discharge. No patient will be allowed to leave alone or use public transportation.
After discharge, the patient's referring urologist resumes the patient's care. Usually, normal diet, normal physical activity, normal sexual activity can be resumed 24 hours after surgery. If the patient has questions or problems, they are to call the referring urologist. All patients are asked to see the referring urologist one to two weeks after surgery. The follow-up visit is extremely important to determine if the procedure was successful and to check for any problems. More than one postoperative visit may be necessary.
The postoperative visit is a good time to talk with the urologist about how to prevent future stones. The referring urologist is required to send a report back to the Center giving the outcome of treatment. If a stent is present at discharge, this must be removed in a timely fashion, usually within 4-6 weeks of being put in. If not removed, severe complications can occur, including the rapid formation of new stones. If the patient is a "stone former," it is advisable to see the urologist every year in the future to check for the silent formation of new stones.