At UCSF, your dedicated team of Endourologists are actively engaged in clinical trials and research to advance understanding and develop novel treatment options to improve outcomes and quality of life for people with bladder stones, kidney stones, bph, cystinuria, and primary hyperoxaluria.

We specialize in cutting edge minimally invasive procedures that include treatment for complex kidney stones, ultrasound guided surgical techniques, advanced robotics and microbubble application to improve stone fragmentation.

The state-of-the-art facility is located at the Parnassus campus where these Urologists offer consultation, diagnostic imaging and lab testing. You can meet with your Urologist in person or through a telehealth visit. Click here to schedule an appointment.

Our comprehensive program

Stones may form in the bladder when the bladder is not emptied completely. This can be due to nerve damage that impairs a patient’s ability to urinate, recurrent urinary tract infections, or an enlarged prostate.  The resulting stones may or may not be associated with symptoms, including blood in urine, pain with urination, weakened urinary stream, or abdominal pain.  Small stones can pass on their own, especially with increased water consumption, but left unattended, they may grow large enough to block the flow of urine, leading to infection or pain.  

Bladder stones can be removed in a variety of manners, from open surgery to minimally invasive endoscopic procedures.  UCSF urologists are expert in minimally invasive methods of bladder stone removal during which the stones are first located by inserting a small camera through the urethra.  Stones are then broken apart using a laser, ultrasound or other mechanical device.  Once broken into smaller pieces, they can be more easily removed, rending the patient stone free.

Kidney stones form when substances that are normally dissolved in the urine concentrate together and aggregate into stones. Kidney stones affect over 40 million Americans every year. They can cause severe pain and often require visits to the emergency room. As an internationally recognized center for urinary stone disease, we focus on treating kidney stones and preventing them from recurring. Studies have shown that patients who have a single symptomatic kidney stone are likely to have another stone within five years if they do not get treatment to prevent recurrence. Our goal is to provide the most advanced treatment for painful kidney stones and also long-term management strategies, such as dietary modification and medical management, to prevent stones from recurring.

At UCSF, we specialize in minimally invasive surgery for kidney stones, including ureteroscopic and percutaneous stone removal in addition to lithotripsy, which uses powerful shock waves to break up stones. These minimally invasive options lead to faster recovery time and improved patient outcomes. We combine our expertise in clinical care with an extensive research program to constantly advance the options for treating patients with kidney stones and prevent recurrence.

The prostate gland is part of the male reproductive system and is located below the bladder, in front of the rectum and surrounds the urethra (structure that carries urine from the bladder out through the penis). Normal prostate glands are about the size and shape of a walnut and weigh about an ounce. The main function of the prostate gland is to produce ejaculatory fluid. The prostate gland often enlarges with age, referred to as benign prostatic hyperplasia or BPH. This condition can cause symptoms such as difficulty emptying bladder, need to urinate frequently, straining, post urination dribbling or weak stream. These symptoms are referred to as lower urinary tract symptoms (LUTS) and occur because the gland is enlarged and blocking the flow of urine.

BPH is a common condition, estimated to affect 50% of men in their 50s and up to 90% of men over age 80. In addition to increasing age, other risk factors include family history of BPH. BPH is not prostate cancer, although the conditions can exist together. Men should be evaluated by a clinician if experiencing BPH symptoms, as this is a progressive disease and can result in bladder damage, infection or kidney damage. BPH symptoms can be treated with oral medications used to decrease the size of the prostate (5-alpha-reducatase inhibitors) or to relax the muscles of the prostate and bladder neck (alpha blockers). Procedures such as Holmium Laser Enucleation of the Prostate (HoLEP), Needle laser surgery, UroLift, and Rezum may need to be performed.

Cystinuria is a relatively rare disease in which people inherit an inability to process an amino acid called cystine.  Excess cystine concentrates in the urine, where it can lead to the formation of stones in the bladder, kidneys, and ureters.  Cystine stones tend to recur, and some people have many, painful episodes every year.  Some patients undergo 30 or more surgeries over the course of their lifetime to remove stones. 

UCSF urologists are experts in cystinuria and the treatment of cystine stones.  Our treatment plan consists of dietary intervention, medical management, and surgery. Our focus is on the prevention of stones and keeping patients out of the operating room.  However, when surgery is necessary, we specialize in minimally invasive techniques that emphasize the preservation of long-term kidney function.  Much of our research is centered on improving treatment for cystinuria patients.

Primary hyperoxaluria is a rare genetic condition in which the deficiency of a specific enzyme causes oxalate, a highly insoluble metabolic end-product, to buildup in the kidneys and/or other organs and may cause the development of multiple and recurrent stones in the urinary tract.  There are three genetically distinct types of primary hyperoxaluria, PH1, PH2, and PH3, dependent on the enzyme that is deficient.  Chronic symptoms, like the recurrent formation of stones and buildup of calcium oxalate in the kidney tissue may lead to kidney disease and kidney failure.  Early diagnosis can help reduce possible complications from this condition. 

Current Endourology & Laparoscopy Fellows
 

 

    Fadl Hamouche, MD
    July, 1, 2020- June 30, 2022
    Residency: 2020, McGill University
    Medical School:  2015, Universite de Sherbrooke,
    Faculte de Medecine
    Publications
    Greg Hosier, MD, MSc
    July 1, 2021- June, 30, 2023
    Residency: 2021, Queen's University
    Medical School: 2016, Dalhousie University

Click here to learn more about the Endourology & Laparscopy Fellowship Program