OHSU's department of urology has a proud tradition in minimally invasive kidney stone treatment. The first percutaneous nephrolithotomy procedure was performed at OHSU in 1983. Over 3000 patients have been treated to date, and OHSU remains the highest volume center for the treatment of complex kidney stones in the Pacific Northwest.
Ten percent of people in the United States today suffer from the presence of one or more kidney stones. While small kidney stones can be frequently managed with shock wave lithotripsy and ureteroscopy, larger stones often require more involved procedures. Very large stones used to be removed through a large incision in the side of the abdomen, but fortunately they can now most often be removed through a 1-inch incision in the back. Known as a percutaneous nephrolithotomy, the procedure is highly effective, and OHSU is home to one of the few urologists in the Northwest that perform this operation.
Dr. Brian Duty is the leading specialist in stone disease at OHSU Urology. He completed a fellowship in minimally invasive urologic surgery with a focus on stone disease at the Smith Institute for Urology in New York, NY. He also places an emphasis on stone prevention through medical management and lifestyle modifications. With his extensive experience, he has published multiple journal articles and textbook chapters on endourologic techniques, and is frequently invited to speak at national and international events.
Medical management of kidney stones
One in ten individuals will develop a kidney stone within their lifetime. Over the past decade, kidney stones have increased greatly in prevalence, most likely due to changes in diet and physical activity trends. Multiple studies have shown that dietary and lifestyle choices are associated with an increased risk of forming stones. Among those that have suffered from one kidney stone, 50% of will form a new stone again within 5 to 10 years.
While great advances have been made in the surgical treatment of kidney stones over the last 30 years, development of effective medical management techniques has lagged behind, and many kidney stone sufferers today are not offered testing to identify risk factors for future stone formation. At OHSU, our providers have specialized training in kidney stone prevention techniques by utilizing dietary changes, supplements, and medication. All patients with a history of stone disease will be offered metabolic analysis of blood and urine samples. In the majority of cases, this will identify at least one risk factor that can be corrected, often by lifestyle changes alone. We frequently collaborate with dietitians at OHSU to create nutrition plans that incorporate our patients' unique medical conditions and nutritional needs.