University Hospital Southampton named global leader in kidney stone research

University Hospital Southampton (UHS) has been recognised as the world’s most active centre for clinical research into kidney stone treatment, according to a new study.

The global analysis, featured in the journal Urolithiasis and conducted by researchers in Turkey, reviewed 3,693 articles on minimally invasive treatments for kidney stones published between 2015 and 2024.

UHS emerged as the top publishing institution globally, with 205 publications, and was also the most cited, with 1,854 citations – a distinction driven largely by the work of Professor Bhaskar Somani, consultant urological surgeon at UHS, and the team in Southampton.

Kidney stone disease has been rising globally over the last decade and now affects up to one in ten people.

Diet and lifestyle factors, including not drinking enough fluids and a high BMI (obesity), are significant contributors to stone formation. While they can affect people of all ages, stones typically peak in the 30 to 60 age range.

The number of hospital admissions for kidney stones has been increasing over the past few years, with Prof Somani previously warning of a kidney stone epidemic, with 60% of men and 50% of women likely to be affected by 2050.

Stones form when waste products in the blood collect inside the kidneys and build up into hard, stone-like lumps. While many are small enough to pass naturally, larger stones can cause severe pain and require removal. If left untreated, they can lead to infections or impaired kidney function.

Minimally invasive procedures offer a safer alternative to open surgery, treating kidney stones with minimal damage to the kidneys and surrounding tissues. These techniques also reduce recovery time and improve patient outcomes.

They include keyhole surgical procedures such as percutaneous nephrolithotomy, and retrograde intrarenal surgery, which uses a ureteroscope – a thin, tube-like instrument – inserted via the urethra into the kidney. Endoscopic combined intrarenal surgery combines these approaches.

Non-surgical options include extracorporeal shock wave lithotripsy, which uses targeted ultrasound or x-ray shock waves to break stones into fragments that can be passed in the urine.

UHS, which treats around 1,200 patients a year with the condition, has long been at the forefront of innovation in this field, with its surgical team pioneering the use of a laser ‘pop-dusting’ technique – a gentler method for breaking down kidney stones into fine dust that can be passed naturally, reducing trauma to the kidney and improving recovery.

The Trust also introduced a groundbreaking twin-surgeon model for treating children with kidney stones. This approach combines the expertise of adult and paediatric urologists in a single procedure, improving outcomes and reducing the need for multiple surgeries – a model now being adopted by other centres across the UK.

Both techniques were developed and refined through UHS’s active research programme, demonstrating how clinical investigation directly informs and improves patient care.

The hospital’s dedicated kidney stone service provides comprehensive care for patients of all ages, from initial diagnosis through to advanced treatment and long-term prevention. The multidisciplinary team includes urologists, nephrologists, specialist nurses and dietitians, offering tailored management plans that address both the physical and lifestyle factors contributing to stone formation.

With access to cutting-edge technology and a large renal stone database, the service is designed to deliver fast, effective treatment and reduce recurrence rates.

Research is embedded into every aspect of the service. UHS leads and collaborates on national and international studies, with a focus on improving surgical techniques, understanding metabolic causes and preventing recurrence. The team also supports training and education, helping to shape the next generation of kidney stone specialists.

Professor Somani’s research journey has been supported by UHS through its Research Leaders Programme. His current focus is on the use of artificial intelligence (AI) to improve care for patients undergoing surgery on their kidneys, ureters, bladder or prostate.

Prof. Somani said: “It is wonderful that our research at University Hospital Southampton has been recognised in this way. Kidney stones are a growing problem worldwide. Our research into minimally invasive procedures is helping to improve care, by preventing complications and hastening recovery.

“Our research directly translates into clinical outcomes and every new technique we develop and refine brings us closer to achieving these outcomes.”

Already established as a centre of excellence in urology, UHS publishes between 100 and 150 peer-reviewed papers annually and shares its findings regularly at national and international conferences – reinforcing its role in shaping global best practice in kidney stone care.