South Florida Hospital News
Wednesday August 5, 2020

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September 2016 - Volume 13 - Issue 3


Z Urology’s Stone Center to Provide More Rapid Relief for Patients

While kidney stones are a fairly common condition, people living in the ‘stone belt,’ where weather is hot and humid year-round, are often more susceptible than those who live outside the Southeast.
“The number one risk factor for kidney stones is dehydration, which is why stone disease is especially prevalent in this area,” explained Dr. Justin Muskovich of Z Urology. “When the body becomes dehydrated, calcium crystallizes in the urine, and as it grows bigger it breaks off and causes problems in the ureter. When a stone blocks the flow of urine, it causes the kidney to stretch, which causes discomfort and pain.”
According to Dr. Muskovich, kidney stones can form in anyone, though people with metabolic difficulties, certain diseases of the kidneys, urinary tract infections and certain disease processes like gout may be more susceptible. “Certain types of medications can also cause them, especially those used in HIV and AIDS therapy,” he explained.
“Stones can also form in the bladder, and are more common in men who have difficulty urinating because of enlarged prostates, or their bladders not working,” he added. “When urine sits in one place, it precipitates calcium, which makes these people more at risk.” Those who have had catheters or suprapubic tubes put in or who have had bladder surgery may also be more prone to developing stones.
Because people who live in the Southeast are more likely to develop stone disease, Z Urology is developing a Stone Center to help patients with the condition. “Because there are so many patients admitted to the hospital, it really puts a burden on the system,” said Dr. Muskovich, adding that not all stone problems need to be surgically treated. “It can take two to three days before a person passes a stone, so if we can get their pain under control and send them home, instead of having them spend those days in a hospital, it’s a big cost-savings measure.”
According to the National Institutes of Health, kidney stones send more than 300,000 people to emergency rooms each year.
In Z Urology’s outpatient surgery center, patients have access to the majority of treatments used to treat kidney stones. “We’re hoping to increase the efficiency of treatment by working together with hospital systems to treat patients in our registered surgery center on an outpatient basis,” said Dr. Muskovich, adding that Z Urology will have this option available to patients within approximately two months.
While some patients can pass stones naturally, others may need surgical intervention. “It depends on the size of the stone; the general rule is that if it’s 5 millimeters or less, it will pass 50 percent of the time,” said Dr. Muskovich. “But I’ve seen smaller ones cause problems, and seen larger ones pass.”
Patients who can’t take medications, who have intense pain or vomiting, or who make repeated hospital visits for kidney stones may need to be treated surgically. “The majority of treatment is minimally invasive, either using a ureteroscope, which involves a laser and a camera, or using extracorporeal shockwave lithotripsy (ESWL) that utilizes sound waves outside the body to fragment stones into smaller pieces so that they can pass more easily,” explained Dr. Muskovich.
While shockwave therapy used to require patients to sit in a tank of water, it can now be done using a gel that simulates the same process while the patient is under anesthetic.
Left untreated, kidney stones can cause scarring of the ureter, which may require major surgery, as well as kidney damage and failure. While many patients do feel pain in their sides as a result of kidney stones, there are not always symptoms.
“People need to drink lots of fluids, especially during this time of year when the weather is hot and they are more active,” said Dr. Muskovich. “If they think that there’s a problem, they need to come in for screening.”
Z Urology has four full-time urologists on staff, as well as a surgeon specializing in stone disease, which ensures that patients can be seen quickly. “We are able to spread the work out so that patients can get in rapidly; for example, the other morning I had two emergency room consults at 6 a.m. and was able to see the patients by 8 a.m. They both were treated by 12:30 that day,” said Dr. Muskovich.
“I am really passionate about this area of medicine, because we are able to make a difference right away,” he added. “People are in pain, and they get almost immediate relief once they’re treated. They’re very grateful.”

For more information about Z Urology’s services or locations, visit or call (954) 714-8200.

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