Barts and The London Urology Centre
Kidney stones generally leave the body with the urine and many stones are formed and passed without any symptoms. If stones grow to too large - usually at least 5 millimetres – they can cause obstruction and pain. Typical symptoms include a colicky pain in the groin or lower back. Sometimes this pain can be so intense it may lead to crippling or fainting bouts.
Our stone service (known as endourology) is one of London’s leading services for the treatment of kidney stones and related conditions. It offers a one-stop service for the diagnosis and treatment of kidney stones.
If you are referred to our urology team for the treatment and removal of kidney stones you will be carefully assessed before our doctors decide how to treat you. This very much depends on the extent and size of kidney stone and your needs and general health. Approaches for temporary bypassing kidney stones and treating kidney stones include inserting a temporary stent, using ultrasonic shockwaves known as lithotripsy, and minimally invasive treatments such as keyhole surgery. See more details below.
Temporary stent
A ureteric stent is a small tube that is inserted between the bladder and the inside of the kidney, and it provides temporary relief from a blocked kidney. A stent will help a patient to save a failing kidney which has been blocked or become infected by a stone.
While the patient is under a general or local anaesthetic, our surgeons carefully insert the stent into the kidney, which allows urine to bypass the stone and drain from the kidney. Most stents can be left in place for some length of time until the stones have passed or been removed with keyhole surgery or sonar blasting.
Lithotripsy (ultrasonic shock-waves)
Lithotripsy is a non-invasive treatment which uses ultrasonic shock-waves. Many shock waves are centred onto the stone where they create a combined shock wave strong enough to break the stone. The aim is that the fragments become tiny enough to pass out with the urine without causing pain.
We are one of few hospital trusts in the UK to have lithotripsy on-site and available on a daily basis to patients for the treatment of kidney stones. We are currently performing around 1000 treatments per year.
This unique facility is ground-breaking for many of our patients as new evidence has shown that lithotripsy offered within 48 hours after renal colic pain leads to a much faster stone clearance and allows patients to return home soon after treatment. Normally patients who have kidney stones removed by surgery require a week’s stay in hospital followed by two weeks at home to recover completely.
Minimally invasive surgery (key hole surgery)
Our state-of-the-art keyhole surgery service (endourology and laparoscopy) is well established and has a national and international reputation in treating patients with stone disease and related conditions.
Keyhole surgery aims at using existing body openings such as the urethra for access to kidney stones. If this is not possible, the diseased area is accessed through tiny 1-2 cm incisions. A camera is inserted into those incisions and the operation is then performed under video-monitoring vision using ultra-small instruments and laser fibres.
Since no major cut is made and no major wound has been created, patients recover much faster than after open operations. Usually, patients are able to leave the hospital in half the time; approximately 1-3 days, and will be back to normal activities in 1-3 weeks following keyhole surgery.
Blockage of the urinary system
Obstructive uropathy means a blockage of any part of the urinary system. Blockages can be caused by kidney stones, organ growth in old age, or malformations such as the narrowing of a kidney outlet.
Treatment is tailored according to the patients needs and can include drugs and, if necessary, surgical removal of the obstruction.