Two Williamsburg Urologists Change the Way Kidney Stones are Treated

Kidney Stones

Small Stones That Cause Big Problems

For those who suffer from kidney stones, finding relief as soon as possible is crucial. When you’re starting to experience symptoms, a trip to the Emergency Room (ER) may only give you slight relief before the pain returns. Two Williamsburg urologists, Geoffrey B. Kostiner, MD, and Joseph R. Habibi, MD, offer a unique approach aimed at helping patients avoid a repeat trip to the ER.



What is a Kidney Stone? How do I Know if I Have One?

Kidney stones (nephrolithiasis) are mineral deposits that form when the solutes, or the chemistry of urine, is imbalanced. These alterations allow the deposits to clump together, forming a kidney stone.


There are several recognizable symptoms for kidney stones such as:

  • Pain on left or right side of the lower back that may wrap around to the stomach
  • Nausea
  • Vomiting
  • Diarrhea
  • Painful, burning sensation when urinating
  • Persistent need to urinate
  • Blood in urine

Types of Kidney Stones

There are four types of kidney stones.

  • Calcium Stones: This is the most common type of stone, caused by dietary factors and metabolic conditions such as obesity.
  • Struvite Stones: These form in response to an infection such as a urinary tract infection (UTI). This type of stone is more common in women.
  • Uric Acid Stones: This type of stone is caused by high uric acid concentrations and acidity.
  • Cystine Stones: These form in people who have cystinuria, a hereditary disorder that causes the kidneys to excrete too much of certain amino acids. These stones are resistant to lithotripsy.

Large, chronic kidney stones that are left in the kidney will cause inflammation over time. This inflammation, left untreated, may cause chronic kidney damage. It’s best to treat these larger stones when they’re found.

How TPMG Urologists Can Help You Find Relief

Kidney stone patients often require repeat emergency care visits (ER or Urgent Care) due to difficulty in obtaining timely outpatient urology. Together, kidney stone specialists Drs. Kostiner and Habibi created a treatment approach to avoid readmission to the emergency room for people who suffer from kidney stones.

With this service, patients are guaranteed a same-day appointment with either Dr. Habibi or Dr. Kostiner. During the appointment, the patient will receive an in-depth consultation, their records will be reviewed, and an X-ray will be taken.  They will then be scheduled for the most appropriate medical or surgical intervention.

A Urologist has extensive specialized knowledge in the prevention and treatment of kidney stones. Seeking early treatment for kidney stones from a Urologist is the ideal way to achieve early relief from acute symptoms and to prevent future kidney stone episodes.

How to Treat and Prevent Kidney Stones

There are several ways to treat and prevent kidney stones. A Urologist’s uniquely specialized training can help you determine the best treatment plan for you.

Treatment Options

  • Medical Expulsive Therapy (MET): alpha blockers, pain medication, and increased fluid intake to allow smaller stones to pass spontaneously
  • Extracorporeal Shock Wave Lithotripsy (ESWL): A common, non-invasive treatment where external shock waves target the stones, causing them to break apart into small pieces to allow for stone passage. This procedure is done with sedation, similar to a colonoscopy.
  • Ureteroscopy: A procedure that involves feeding a small telescope (ureteroscope) into the urethra and bladder to allow direct access to stones in the ureter (tube connecting kidneys to the bladder) and kidney. Small stones may be removed with a basketing device whereas larger stones can be broken into smaller pieces with a laser for easier removal. This is a procedure performed under general or spinal anesthesia.
  • Percutaneous Nephrolithotomy with Lithotripsy (PCNL): The most invasive “minimally invasive” approach that is reserved for larger renal stones.


After your kidney stone treatment, Drs. Kostiner or Habibi become your partners in your health care. Once you have one kidney stone, the chance of another occurring within a five-year time frame is approximately 50 percent. Some preventative measures that can be taken are:

  • Metabolic Evaluation: A test that will look at the makeup of your urine. By identifying urine abnormalities, our Urologists can intervene with lifestyle and medical approaches to decrease your future risk of having another kidney stone by approximately 50%.
  • Hydration: Staying hydrated is one of the best ways to help reduce your risk of forming kidney stones.

Once a kidney stone is discovered, a urologist will help you determine a treatment plan that best suits your specific condition. A few tips to help you remain stone-free include eating a balanced diet, drinking appropriate amounts of fluids to maintain light-colored urine, and maintaining a healthy weight. If you suffer from kidney stones, find support from your friends, family, and doctor in your health care journey.

Geoffrey Kostiner

About Geoffrey B. Kostiner, MD

Geoffrey B. Kostiner, MD, is a Diplomate of the American Board of Urology. He provides treatment and care for a variety of urological conditions including prostate issues, urinary incontinence, and kidney stones with a particular interest in minimally invasive surgery. Dr. Kostiner is an active member of the Williamsburg-James City County Medical Society, the American Urological Association, and has been a member of the American Medical Association for over 20 years.

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