Kidney and ureteric stones are a core focus of Mr Charitopoulos’s practice. He provides thorough assessment and modern, minimally invasive treatments—including ureteroscopy, laser lithotripsy, ESWL and percutaneous techniques when required, with the aim of achieving stone‑free status quickly, safely and with minimal discomfort. His approach goes beyond treating the acute episode: he takes time to explain each step, discuss options clearly and support patients throughout their recovery. He also places strong emphasis on long‑term kidney health, offering full metabolic evaluation and personalised prevention strategies so patients feel confident about reducing their risk of recurrence. Mr. Charitopoulos’s deep interest and involvement with conferences, research and MDTs enables him to bring the latest cutting edge treatments to his practice.
Kidney stones form when certain substances in the urine, such as calcium, oxalate, uric acid or cystine become too concentrated and begin to crystallise. Factors that increase this risk include low fluid intake, high‑salt or high‑oxalate diets, metabolic abnormalities, recurrent infections, obesity and genetic predisposition. Over time, these crystals can grow into stones that may remain in the kidney or move into the ureter, causing pain or obstruction. Understanding why stones develop is a key part of the treatment, as targeted dietary advice, hydration strategies and medical therapies can significantly reduce the likelihood of future stone formation.
To identify the underlying cause, Mr Charitopoulos carries out a structured metabolic assessment that may include blood tests, urine analysis and, when appropriate, a 24‑hour urine collection to measure levels of calcium, oxalate, uric acid, citrate and other stone‑forming substances. Whenever possible, he arranges analysis of any passed or removed stone, as its composition provides valuable insight into the triggers. Imaging helps identify anatomical factors, such as obstruction or drainage issues that may predispose someone to stones. By combining these findings with a detailed dietary and medical history, he can pinpoint modifiable risk factors and create a personalised prevention plan that meaningfully reduces the chance of recurrence.
Methods frequently used in the treatment of kidney stones include:
Ureteroscopy and flexible ureteroscopy
Ureteroscopy uses a thin, flexible or rigid telescope passed through the urethra and bladder into the ureter and kidney to visualise the stone directly. Modern ureteroscopes allow access to stones throughout the urinary tract without skin incisions. Under direct vision, small stones can be removed with baskets, and larger stones fragmented using a laser. This approach is commonly used for ureteric and many renal stones and typically allows rapid recovery and usually day-case hospital stays.
Laser lithotripsy
Laser lithotripsy is performed through the ureteroscope to fragment stones into passable fragments or dust them into very small particles. The laser energy is delivered via a fibre and can be precisely targeted under direct vision, minimising injury to surrounding tissue. Laser lithotripsy is highly effective for a wide range of stone types and sizes and is frequently combined with ureteroscopy as a single‑session treatment.
Percutaneous techniques (Percutaneous Nephrolithotomy)
Percutaneous nephrolithotomy (PCNL) is a minimally invasive operation for larger or complex renal stones. A small skin incision is made in the flank and a tract is created directly into the kidney to allow instruments to remove or fragment stones under imaging guidance. PCNL achieves high stone‑free rates for large stones but usually requires a short hospital stay and is chosen when ureteroscopy or ESWL are unlikely to clear the stone completely. Recent evidence compares PCNL and ureteroscopic approaches to help select the optimal option based on stone burden and patient factors.
Shock Wave Lithotripsy (ESWL)
Extracorporeal shock wave lithotripsy (ESWL) uses externally generated shock waves focused on the stone to break it into smaller fragments that can pass naturally. ESWL is non‑invasive, often performed as an outpatient procedure, and is most suitable for smaller stones in favourable locations. Its effectiveness depends on stone size, composition and patient anatomy; some patients may require repeat sessions or adjunctive procedures if fragments do not clear.
