When it comes to treating kidney stones, especially large kidney stones, many patients ask, what is the difference between a urologist and a nephrologist?

While both urologists and nephrologists treat kidney problems, the main difference lies in the surgical training.

  • Urologists are surgeons who have specialized training and experience in the diagnosis and treatment of disorders of the urinary system in men and women, including the kidneys, as well as disorders of the male and female reproductive system. Urologists have the surgical skills necessary to treat conditions ranging from kidney stones to kidney, bladder, testicular and prostate cancers as well as urinary incontinence, pelvic health conditions, and male reproductive issues such as erectile dysfunction.  

  • Nephrologists are doctors who focus on conditions that affect the way in which the kidneys function such as inflammation of the kidneys, chronic and end-stage kidney disease and diabetes. They diagnose and utilize non-surgical medical therapies for managing kidney diseases and complications from other medical conditions that impact the kidney’s ability to filter waste from the body.  



Davalos with female patient 1While nephrologists can manage small kidney stones that can be passed through the urinary tract and can prescribe medications that may help prevent stones, most patients benefit from the surgical expertise of a urologist, especially when faced with recurrent or large, complex kidney stones.

A urologist is specially trained to not only diagnose and treat small and large kidney stones, but also focuses on prevention of future kidney stones.

Metabolic medical management is the focus on what causes the formation of kidney stones and the development of an individualized care plan for preventing future stones. This prevention plan often includes lifestyle and diet modifications including increasing fluid intake and limiting sodium in the diet.

At Chesapeake Urology, our urologists utilize several non-surgical and minimally invasive surgical techniques to treat and remove small and large kidney stones including:

  • Shock Wave Lithotripsy (SWL), a non-invasive option for people with smaller stones that are too large to pass on their own. High energy shock waves are delivered to the stone to break up the stone(s) into very small particles that can then be passed through the urinary system.

  • Ureteroscopy/renoscopy is a minimally invasive procedure that utilizes a small scope passed into the urinary tract or kidney to locate, break stones into tiny pieces utilizing a special laser, and remove stones. In some cases the tiny stone fragments can be passed through the urinary system.

  • PCNL, or Percutaneous nephrolithotomy, and tubeless PCNL are innovative surgical treatments for patients who have large, complex kidney stones (larger than 2cm in diameter) that cannot be treated successfully with other therapies. Percutaneous refers to a minimally invasive surgical technique performed via a small incision through the skin, rather than an open, more invasive procedure.

In fact, Chesapeake Urology’s large kidney stone specialists are among the nation’s foremost leaders in these techniques that results in minimal trauma to the kidney, complete stone removal, fewer complications than open surgery, and a quicker recovery.


If kidney stones are a recurring problem and surgical removal of large kidney stones is necessary, seeing a urologist with expertise in kidney stone removal and advanced surgical techniques such as Tubeless PCNL will benefit patients and help prevent future stones.