Surgeon halves kidney stone treatment with new technique

Bilateral stones stentA Southampton surgeon is halving the amount of treatment patients require to remove kidney stones.

Bhaskar Somani, a consultant urological surgeon at Southampton General Hospital, is pioneering the use of a technique to clear both organs in the same procedure, known as bilateral simultaneous ureteroscopy. 

It involves using a combination of a viewing instrument, known as a ureteroscope, to visualise and position stones and a laser beam to break them up.

Patients with renal stones, which develop when crystals of salt accumulate into stone-like lumps and are not flushed out of the body, traditionally undergo treatment on each kidney individually during separate hospital admissions. 

The condition, which affects around 10 to 15% of the male population and 3 to 7% of women between the ages of 20 and 60 years, can lead to stone blockages in the urinary system and cause pain and recurrent urinary tract infections or sepsis.

“The idea is to clear all stones in both kidneys at the same time rather than individually as patients then only have to undergo one procedure and, as a result, only one anaesthetic,” explained Mr Somani.

“In particular, for patients with urinary tract infections who have stones in both kidneys, it is sensible to try and clear everything at once as you can’t be sure which side is causing the infection.

“Many surgeons may be fearful of attempting both sides due to the risk and worry of causing trauma to the kidneys but, with the right expertise, confidence and experience, the benefits of a single procedure far outweigh the risks of performing more work in a single session.”

In a recent study, presented at a regional meeting of the British Association of Urological Surgeons, Mr Somani reported 22 bilateral simultaneous ureteroscopies to remove stones of a combined size of 21mm.

The technique was performed with a stone-free success rate of 92% and patients suffered minimal complications, which is comparable to outcomes recorded following individual procedures. 

In addition, more than three-quarters of patients went home the same day.

“Our data, which we believe is the first published and presented series in the UK, suggests this is a safe and effective technique with minor complications that are equivalent to individual procedures and can be used as standard treatment,” he said.

“Performing them separately means they have more hassle, more time off work and, logically, if both stones can be removed at the same time then why do it at different times and prolong discomfort for these patients.”

He added: “Stone treatment no longer has to be carried out in a staged manner when we have a chance to make people stone-free in one sitting.”

Posted on Tuesday 18 March 2014