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Endourology
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Urology

Endourology

Endourology is a minimally invasive approach to treating primarily kidney stones, but also other urologic conditions, such as ureteral/intra-renal strictures and other disorders obstructing the urinary flow. While many physicians treat kidney stones, the urologists at the Department of Urology at Montefiore Medical Center are internationally recognized leaders in many endoscopic (minimally invasive) techniques, and work to customize the optimal treatment plan for each patient, including preventative measures to help avert the recurrence of kidney stones in the future.

Kidney stones affect 10-12% of the American population, ranging from children to senior citizens, and both men and women. However, numerous factors such as diet, genetic metabolic disorders (such as hyperoxaluria, hypocitraturia, and hypercalciuria), genetically inherited disease (such as cystine stone disease), and geographic location contribute to the development of kidney stones, so each patient's case differs from the next.

A Customized, Multidisciplinary Approach for Each Patient

At Montefiore Medical Center, we treat patients with all types of kidney stones, ureteral/renal strictures (scarring), and kidney obstructions with an emphasis on personal attention. We conduct a stone analysis and metabolic evaluation to assess risk factors, discuss each patient's history in depth, and customize a strategy regarding diet, supplements, and laparoscopic surgery, if necessary, to treat kidney stones, educate patients about their specific condition, and implement a preventative plan. Our goal is to cure each patient's disease, alleviate suffering, and prevent future episodes from occurring.

Our unique hands-on, proactive treatment strategy, coupled with our multidisciplinary approach, results in excellent success rates with a focus on total patient care. We work closely with radiologists, interventional radiologists, endocrinologists, pathologists, and other specialists as required, so patients may benefit from the experience and knowledge of a team of experts. Additionally, we have found that of those requiring surgery, approximately 95% are candidates for minimally invasive procedures, which reduce pain, scarring, and blood loss, and expedite patients' discharge from the hospital and overall recovery.

A highly sought-after endourologist in the United States, David Hoenig, MD has pioneered various minimally invasive techniques, including Shock Wave Lithotripsy, Ureteroscopy, Percutaneious Stone Surgery, and combinations of these procedures when necessary. A combination of less invasive methods treating large stones may be particularly suiting for patients with severe operative risks, and while this treatment modality may require more than one outpatient procedure, patients have realized a 90% success rate in managing some of the most complex kidney stones.

Dr. Hoenig has also compared the outcomes of obese and non-obese patients who have undergone laparoscopic nephrectomy and percutaneous stone removal, and is one of a small number of physicians in the New York Metropolitan area who conducts cryoablation for kidney lesions. He is highly referred to for all phases of minimally invasive surgery, including stone disease, reconstructive surgery, and cancer surgery.

Groundbreaking Procedures and Services

Endourologists at Montefiore Medical Center offer unparalleled care for all kidney stones (ureteral, cystine, complex staghorn, horseshoe/anatomically abnormal stones, etc.), kidney obstructions from strictures, and benign and malignant renal lesions. We also offer the entire spectrum of minimally invasive treatment modalities including:

  • Urethroscopy to treat strictures or blockages of the urethra
  • Cystoscopy to treat bladder stones and tumors
  • Ureteroscopy for tumors of the ureter or kidney collecting system
  • Laparoscopic procedures (all phases of kidney disease, both cancer and benign)
  • Percutaneous renal surgery (placing catheters through the skin of the back to drain the kidney and dilate the passageway so instruments may be inserted to break up and/or remove stones) for stones or tumors of the kidney collection system
  • Extracorporeal shock wave lithotripsy (ESWL)
  • Treatment of renal obstruction via ureteroscopy or percutaneous surgery
  • Cryoablation for kidney lesions
  • Reconstructive procedures (i.e.laparoscopic pyeloplasty for ureteropelvic junction)

Progressive Research

The Department of Urology at Montefiore Medical Center actively engages in clinical and basic research endeavors to continually improve patient care and new minimally invasive techniques and technologies. Currently, we are conducting various studies to evaluate the metabolic consequences for kidney stone and laparoscopic surgery, such as future renal function, obesity, and medical diseases. We have also explored outcomes of percutaneous surgery as they correlate to body mass index and kidney stones, the use of holmium laser lithotripsy, and laparoscopic treatment (nephrectomy, partial nephrectomy, and cryoablation) of renal lesions. Our discoveries and conclusions have appeared in a myriad of medical journals and are presented nationally and overseas, so that we may contribute to the overall wellbeing of patients.