Kidney stones are a common part of urology care, with one in 10 people experiencing them at least once in their lifetime.
But no two stones are exactly alike. They can vary in size, shape, and composition, and they don’t all cause symptoms in the same way. While smaller stones may pass on their own, larger stones may require additional treatment options.
In this blog, Dr. Mark V. Silva will discuss his specialization in treating large kidney stones using a minimally invasive approach that differs from other common surgical options.
The information in this blog was featured in Dr. Silva’s video, “Large Kidney Stones: How Do Urologists Treat Them?” As always, this content is meant to be educational and should not be considered as medical advice. Please reach out to your doctor if you have specific questions.
A large kidney stone is usually over 6mm, and symptoms usually include:
While even larger stones can pass on their own after a few days, you can still see a urologist if you are experiencing these symptoms to get some relief.
“All urologists will [treat] kidney stones,” Dr. Silva said. “That’s the bulk of every urologist’s practice.”
The PCNL (or percutaneous nephrolithotomy) technique involves a small incision in the back (about the size of a quarter), allowing the physician to access the kidney with a specialized scope. The stone is then broken into smaller pieces and removed, helping relieve symptoms and prevent future complications.
Typically, patients undergoing this type of kidney stone treatment may stay in the hospital overnight, have a tube placed in their back, and undergo multiple tests during their stay.
But Dr. Silva aims to help patients return home the same day whenever possible and avoid placing a tube in the back. The focus is on providing safe, effective care while minimizing disruption to daily life.
“[With] my patient population, I try to get them home the same day,” Dr. Silva says. “I try to get them home without a tube in their back.”
While patients can expect to feel a little sore or achy the next few days, Dr. Silva says that patients can often go back to their normal routines and activities right away if they feel up to it.
You can read more about this procedure in our blog, “PCNL for Kidney Stones: What It Is, What to Expect.”
Whether you’re looking for help with large kidney stones or another urological issue, Greater Boston Urology is here to help with its patient-first philosophy. Our compassionate care team understands that these visits often relate to sensitive topics and treats patients with the respect they deserve.
“It’s when people are at their most vulnerable,” Dr. Silva said.
Treatment plans are not one-size-fits-all. Instead, care is individualized to match each patient’s lifestyle, preferences, and comfort level.
Providers take the time to discuss options and ensure that recommended treatments align with what patients feel ready and willing to pursue.
“We make sure that our treatment algorithm and what we plan for you works with your lifestyle, works for your care, because we can’t say, ‘Take this medication or go for the surgery,’ if it’s not part of the care you really want to go forward with,” Dr. Silva said. “So we really individualize everybody’s care such that it’s something that they can really find achievable.”
The goal is simple: to create care plans that feel achievable, supportive, and centered around the patient as a whole person—not just a diagnosis.
Request an appointment at one of GBU's convenient locations to see the difference our team can make with your urological health.