Day case kidney stone procedure 'could save 10,000 bed days'

A day case procedure being used by surgeons in Southampton to remove kidney stones could save the NHS up to 10,000 bed days a year if replicated across the country.

Mr Bhaskar Somani, honorary senior lecturer at the University of Southampton, and a consultant urological surgeon at University Hospital Southampton NHS Foundation Trust (UHS), and his team are performing more than three times the amount of ureteroscopies in a day than the national average.

The minimally invasive procedure involves inserting a ureteroscope, which is a thin tube used for viewing, into the kidney via the bladder to visualise stones before removing them using a small forceps-like tool.

Kidney, or renal, stones develop when crystals of salt accumulate into stone-like lumps and are not flushed out of the body.

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.

In a study presented at the European Association of Urology Congress in London, Mr Somani and his colleagues reported 78% of 544 stone removal procedures using ureteroscopy were performed at UHS between 2012 and 2016 with a success rate of 95% and a low complication rate of 4%.

The majority of ureteroscopies result in an overnight stay in hospital, with the national average for procedures completed in a day at just 22%.

In November, Mr Somani warned the country faces a kidney stone “epidemic”, with one in seven people now likely to require hospital treatment for the condition.

“With rising prevalence of stone disease and increasing pressures on the NHS as a whole, any changes which can be made to speed up treatment for patients and reduce hospital stays are extremely welcome,” explained Mr Somani, who has published 50 papers on ureteroscopy in the past five years and leads an international training programme on the technique.

“What we have shown in Southampton over a sustained period of time and in published research is that day case ureteroscopy for kidney stones is viable, successful and has an extremely low complication rate.

“On a national scale, if we look at pulling the national average up in line with our performance of 78%, there is scope to prevent around 10,000 patients a year requiring a hospital stay of one day.”

Press release courtesy of University Hospital Southampton NHS Foundation Trust.