Manoj J. Monga, MD, FACS, FRCS

Manoj J. Monga, MD, FACS, FRCS

The University of California, San Diego

San Diego, California

Manoj J. Monga, MD, FACS, FRCS, is a Professor and the Chair of the Department of Urology at the University of California, San Diego, where he oversees the department’s research, teaching, and clinical care. He is recognized as an international authority in endourology (minimally invasive urologic surgery) and kidney stone disease. His clinical expertise includes kidney stone prevention, medical and surgical management of kidney stone disease, and endoscopic management of upper tract transitional cell cancer and benign strictures.

Dr. Monga earned his medical degree from the University of Health Sciences Chicago Medical School in North Chicago, Illinois. He completed a fellowship and residency in General Surgery and a residency in Urology at Tulane University in New Orleans, Louisiana.

Dr. Monga has over 400 peer-reviewed manuscripts, and his work has been included in publications including the Journal of Endourology, the Journal of Urology, Gastroenterology Research, Urology Practice, and the International Journal of Microbial Ecology. He has co-edited books on ureteroscopy, endourology, dietary stone prevention, and percutaneous renal surgery, and has contributed chapters to more than 40 books. Dr. Monga has innovated and developed medical devices related to the treatment of kidney stones, lectured on endourology and stone disease at national and global events, and volunteered for urology missions at hospitals in India and Ukraine. He previously served as Secretary of the American Urological Association, where he advocated for racial and gender diversity and shared governance within the field and organization. Dr. Monga currently serves on the American College of Surgeons’ Board of Governors.

Talks by Manoj J. Monga, MD, FACS, FRCS

Stone Disease Workup and Treatment

Stone Disease Workup and Treatment

| Oct 2023

Manoj J. Monga, MD, FACS, answers patients’ commonly asked questions about food, drink, and supplement choices for kidney stone prevention. He first acknowledges the overwhelming role of genetics in calcium oxalate stone formation. Dr. Monga then compares sodas made with phosphoric acid versus sodas made with citric acid, explaining the effects of each on stone formation, explaining that phosphoric acid is detrimental to the kidneys. He continues by analyzing the beneficial alkali content of coconut water and the impact of black and green teas on kidney stone formation.

Dr. Monga then addresses the role of dietary citrates, emphasizing that foods rich in citric acid are good for the kidneys, and foods rich in potassium citrate are bad for the kidneys. He also explains that a higher calcium and lower salt intake may help stone prevention. Dr. Monga considers supplements as well, noting that fish oil can help decrease urinary calcium while increasing urinary citrate.

Dr. Monga continues by evaluating several oxalate-rich foods, all of which raise the risk of stone formation. He completes his discussion with a comparison of milk chocolate versus dark chocolate, emphasizing that milk chocolate is better for reducing the risk of stone formation.

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Point-Counterpoint: Mini-PCNL vs. Standard PCNL – Standard PCNL

Point-Counterpoint: Mini-PCNL vs. Standard PCNL – Standard PCNL

| Sep 2023

Manoj J. Monga, MD, FACS, compares mini percutaneous nephrolithotomy (mini-PCNL) for renal stone removal to standard percutaneous nephrolithotomy (PCNL). He discusses the different risks and benefits of mini PCNL versus standard, finding in favor of the more reliable and less expensive standard PCNL.

In this presentation, Dr. Monga discusses:

The history of Mini PCNL and Standard PCNL
Increased sepsis and other infection risk in Mini PCNL patients
Which variables are predictive of post-operative success

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Point-Counterpoint: 24-Hour Urine Tests vs. Empiric Therapy – Empiric Therapy

Point-Counterpoint: 24-Hour Urine Tests vs. Empiric Therapy – Empiric Therapy

| Sep 2023

Manoj J. Monga, MD, FACS, presents his argument for empiric therapy over 24-hour urine testing in kidney stone evaluation. Dr. Monga begins by explaining empiric therapy, including empiric dietary therapy, and describes it as a conservative treatment plan. He displays data on the effects of drinking fluids on reducing recurrence of kidney stones, as well as the positive effect of fruit and vegetable intake in terms of reducing kidney stone recurrence.

Dr. Monga then shifts gears to empiric medical therapy, displaying encouraging study data on the use of thiazides to reduce stone recurrence. He also displays data on citrates and stone recurrence, pointing out that this data is weaker, and asserting that citrates should not always be used with patients with kidney stones.

Dr. Monga acknowledges that not many stone patients—even high-risk stone patients—get a 24-hour urine test and that number is actually dropping. He also displays data showing that the use of a 24-hour urine test has no bearing on three-year recurrence across patient populations. Dr. Monga concludes by citing this lack of supporting data for the 24-hour urine test, and re-emphasizes the ease, speed, and efficacy of empiric therapy for patients suffering with kidney stones.

This lecture is part of a Point-Counterpoint debate. Its opposing lecture is “Point-Counterpoint: 24-Hour Urines vs. Empiric Therapy–24-Hour Urine Tests.

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Mini PCNL versus Standard PCNL

| Mar 2022

Manoj J. Monga, MD, FACS, Professor and Chair of Urology at the University of California, San Diego, compares mini percutaneous nephrolithotomy (mini PCNL) for renal stone removal to standard percutaneous nephrolithotomy (PCNL). He begins by looking at who needs a PCNL, explaining that he typically performs them on patients with a stone larger than 15mm, but that he also sometimes performs PCNL on stones when there are anatomical considerations that would make it difficult to get to the stone ureteroscopically. Dr. Monga notes that PCNL has the best outcomes and results in the best quality of life of any stone removal technique. He then poses the question: Why not treat every stone with PCNL? The answer, of course, he says, is because 4/1000 patients die from PCNL due to sepsis. Dr. Monga then moves on to discuss mini PCNL, noting that it was originally assumed to potentially be safer than PCNL, but that a 2001 study showed there was no advantage. He also observes that the smaller sheath used in mini PCNL actually increases the risk of infectious complications, and that outcomes are worse and operating room time is longer with mini PCNL compared to standard. However, Dr. Monga notes, there does appear to be a lower risk for bleeding and fewer transfusions, which might result in less kidney volume loss.

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