Kidney stones are extremely common, with 1 in 7 men, and 1 in 20 women, getting stone symptoms during their lifetime. Importantly, they can occur at any age, and more than 50% of patients who develop one kidney stone will develop another one at a later time in their life.
There are different types of stones, such as calcium stones, uric acid stones and stones associated with infection.
When you see Professor Shergill for a consultation, he will assess whether you may have kidney stones, where they may be in the urinary tract and crucially how much they are affecting your day to day activities. Currently, in 21st century practice, the best test to diagnose stones is a dedicated CT scan. This allows Professor Shergill to establish how many stones you may have, where they are, the size and indeed the possible consistency of them. This will allow joint decision making regarding possible treatment options.
Active treatment options include Lithotripsy (external shock waves to break up stones), FURS Laser (camera inspection of the kidney with a tiny camera and laser to break stones internally), or PCNL (keyhole surgery through the back).
Lithotripsy is done with painkillers and local anaesthetic (patient is awake) as an outpatient procedure. It typically takes 30-40 minutes and uses soundwaves break up kidney stones. It is very well tolerated. FURS Laser uses a camera to find the stones internally, which are then gently broken up with a laser and fully removed. It is performed as a one-day case procedure under a short general anaesthetic. PCNL is reserved for very large stones which cannot be effectively treated any other way.
Crucially, after treatment, Professor Shergill will discuss strategies to try and prevent stone recurrence in the future. This may involve testing of urine constituents, and importantly, has been seen by many patients as beneficial to avoid future problems.
Patient case history 1: Gentleman with pain from kidney stones
JS had been suffering from pains in his abdomen for a few weeks and was feeling frustrated as no clear diagnosis had been made. It was affecting his work in Chester Business Park, and he decided to see Professor Shergill, at Nuffield Chester, who diagnosed a kidney stone, showing him the findings clearly on a CT scan. Professor Shergill offered several options for treatment, and JS chose to undergo shock wave treatment. The treatment was performed under local anaesthetic as a day case procedure and was very well tolerated by JS. The stone was broken up and JS subsequently managed to pass the fragments with ease. At follow up, Professor Shergill confirmed that the stone had passed. Mr JS was well, the pain had resolved and he was back to work by that stage.
Patient case history 2: Modern laser surgery for Accountant with kidney stones
PG had been seen as an emergency with kidney stones causing blockage, and had undergone emergency operation, with stent insertion. Over the next few weeks, the stent caused significant pain and problems (probably worse than the stone itself!), including blood in the urine, frequency of passing urine, and began to affect his work as a Tax Accountant. He made an urgent appointment to see Professor Shergill, at Spire Abergele Rooms, who saw him the same day. Professor Shergill offered several modern treatment options for kidney stones, and PG decided to undergo Laser surgery, which was scheduled the very next week. Operation was performed successfully, quickly and safely at Spire Yale Hospital, Wrexham, as a one-day case procedure. PG became stone free and stent free immediately. He was able to return back to work quickly, in time to complete tax returns for his clients. The stone fragments removed at time of operation were analysed and when PG was reviewed at the follow up clinic in Abergele, Professor Shergill explained that he had Uric acid stones, which could be prevented from recurring, with medical treatment. PG has not been troubled with stones again and has taken up golf now with a 14 handicap!