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Welcome to the Macarthur Urology Website. We are a practice of four urologists who service both public and private patients of Southwest Sydney and the Southern Highlands.

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At Macarthur Urology, we aim to provide the best possible patient care with the most up to date techniques including Robotic and Laparoscopic Surgery.

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We provide management of all urological conditions including urological cancer surgery, urinary stone surgery, management of urinary dysfunction.

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Urinary stones are deposits of minerals (most commonly calcium) that develop over time in the kidneys.  They arise due to abnormalities in the metabolism of various compounds by the kidney which leads to crystallization and deposition of minerals in the kidney. 

They are especially prevalent in Australia due to a hot climate that results in dehydration, less urine production as well as urine that is more concentrated.  Whilst stones are usually made of calcium, they can also occur due to infection (occasionally resulting in very large stones called staghorn calculi), or due to the mineral that causes gout (uric acid).


  • Kidney stone related pain is often severe, and typically located in the loin, groin or testicle.  It may be associated with nausea and vomiting.  The pain is typically due to the obstruction that the stone causes rather than the presence of the stone itself.

    If left untreated, this obstruction can be complicated by infection which may lead to life-threatening septicaemia.  If the stones are not causing obstruction, they may cause no symptoms at all, or some mild symptoms such as a dull ache in the loin or occasional blood in the urine (haematuria).


    Depending on the size of the stone and its location, various options are available

  • 1. Observation and pain relief.  If the stone is small (<5mm) and seems to be in the process of passing, a trial of observation with medical therapy is an option.  Pain relief with the addition of a medication that relaxes the ureter (the tube that passes from the kidney to the bladder) can facilitate the passage of the stone and avoid the need for surgery.

  • 2. Ureteric stent insertion.  This involves a general anaesthetic and passage of a special telescope (cystoscope) through the urethra (that is the eye of the penis in men and the waterpipe within the vagina in women) and into the bladder.  A soft plastic tube is then used to bypass the stone and unblock the kidney.  This relieves the obstruction and pain caused by an obstructing stone, and can be lifesaving in the presence of an infection.  The stent stays within the body until the stone is subsequently treated.  Stents can cause side effects such as blood in the urine, increased urinary frequency and a sensation of flank discomfort that is usually self-limiting.

  • 3. Ureteropyeloscopy and laser.  This involves using a special tiny telescope that passes through the urethra up into the ureter and kidney to visualize the stones.  We then use a Holmium laser to explode the stones into tiny fragments that we can remove, or if small enough, allow to washout by themselves.  This procedure typically does not require overnight hospitalisation.

  • 4. Percutaneous Nephrolithotomy.  This is reserved for stones in the kidney >2cm.  It involves accessing the kidney through the skin of the flank with a needle and wire, and then stretching the incision to approximately 1cm.  A telescope is then passed into the kidney and a Pneumatic Lithoclast (which is like a jackhammer) is used to break up the stone, graspers are then used to pull out the fragments.  This procedure typically requires 2-3 nights in hospital.

  • 5. Extracorporeal Shock Wave Lithotripsy.  This involves using shock waves produced outside the body and focused onto the location of the stone.