Treating Stone Disease

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Kidney Stones

The Department of Urology is an international leader in the treatment of kidney stones and other urologic diseases.


The Department began offering state-of-the-art minimally invasive treatments of kidney stones such as shockwave lithotripsy, percutaneous nephrolithotomy and ureteroscopy with laser lithotripsy in the mid-1990s. This was hallmarked by the Department acquiring Wisconsin’s first Holmium Yag stone laser in 1996, the first spark-gap shockwave lithotripter with inline fluoroscopy in 1998 and the establishment of the first Metabolic Stone Clinic in 1995.


Drs. Sara Best, Stephen Nakada, Sri Sivalingam and Sean Hedican offer kidney stone patients state-of-the-art therapy and prevention through clinical and electronic services.Since that time the Department has treated patients from Wisconsin, the continental United States and internationally. UW Health urologists perform more than 100 complex percutaneous stone removals and nearly 500 ureteroscopic stone therapies annually, and continue to have an active shockwave lithotripsy practice.


In addition, the urologists treat upper tract transitional cell carcinoma in a non-invasive fashion using a kidney sparing approach with the endoscope and laser ablation energies. Due to this leadership position, the Department has published its experience with percutaneous stone removal in the morbidly obese, shockwave lithotripsy, ureteroscopy and laser lithotripsy, metabolic stone clinic effects and even laparoscopy for stone disease.


Looking toward the future the Department continues to work with UW Health radiology colleagues to identify novel pre-operative techniques for selecting the best treatment modality for patients with stone disease. This includes investigations in stone density, skin-to-stone distance and stone volume using axial imaging techniques.


What has amplified UW Health’s academic and clinical expertise in endourology is the fact that the Department has offered a clinical fellowship in endourology since 2002. UW fellows are fully trained urologists who come to Madison specifically to gain expertise in endourology, stone disease and laparoscopic and minimally invasive techniques for the treatment of upper tract disease.


The future holds promise for dietary and medical prevention of stone disease, as well as ongoing treatment options for stone formers which will improve their day-to-day functioning and quality of life. Department of Urology researchers are currently spearheading research in this area.




Penniston KL, Nakada SY. Health-related quality of life differs between male and female stone formers. J Urol 2007; 178(6):2435.


Penniston KL, Nakada SY. Preventative management of recurrent urolithiasis: Medical and dietary approaches. Sem Prev Altern Med 2007; 3(2):67.


Sterrett SP, Penniston KL, Wolf JS Jr., Nakada SY. Acetazolamide is an effective adjunct for urinary alkalization in uric acid and cystine stone formers recalcitrant to potassium citrate. Urology 2008; 72(2):278.


Best SL, Nakada SY. Flexible ureteroscopy is effective for proximal ureteral stones in both the obese and non-obese patients: A two-year, single surgeon experience. Urology 2011; 77(1):36.


Penniston KL, McLaren I, Greenlee RT, et al. Urolithiasis in a rural Wisconsin population from 1992 to 2008: Narrowing of the male-to-female ratio. J Urol 2011; 185(5):1731.