Smith, a woman diagnosed with cystinuria in her early 20s, faced significant challenges due to the rare genetic condition that causes kidney stones. Initially, a procedure in Mississippi led to the removal of one of her kidneys. “It was very upsetting,” Smith stated.
Years later, while living in Hawaii, Smith experienced a ureter obstruction and was flown to Honolulu for emergency care. Her father, a family physician, advised her to seek specialized treatment at Duke University. There, she underwent lithotripsy to break up the kidney stone into smaller pieces.
After two decades without complications, Smith’s bloodwork revealed decreased kidney function following her move to Asheville. Suspecting another stone, she opted for an ultrasound which confirmed its presence. Despite being referred locally, Smith chose Duke for further treatment.
At Duke Health, urologist Robert Medairos presented two options: percutaneous nephrolithotomy (PCNL) or ureteroscopy. “The way they presented me with options made me feel like it was a true partnership,” Smith remarked.
Smith initially chose PCNL but during the procedure in August 2024, Dr. Jodi Antonelli decided against it due to concerns about her delicate kidney anatomy. Instead, Dr. Antonelli placed a stent and planned for ureteroscopy using new technology developed by Duke Health urologist Glenn M. Preminger.
The Continuous Vacuum and Irrigation System (CVAC) used during ureteroscopy allowed for suctioning stone fragments directly from the kidney. “The use of suction in ureteroscopy is a game changer,” said Dr. Antonelli.
Nearly a year later, Smith remains free of kidney stones and expresses gratitude towards Duke’s specialists. “My experience has always been fantastic,” she said.
