Complex multiple kidney stones removed using the new innovative 90-degree Supine PCNL technique in the UAE

Procedure performed at RAK Hospital, the method being less aggressive and facilitates the treatment of large and complex kidney stones

  
  • 26-year old man alleviated from months of persistent pain
  • 1 in 20 suffer from Kidney stones once in their lifetime
  • Complications of Kidney stones can be life-threatening, resulting in blood poisoning, renal scarring, permanent Kidney failure, bladder blockage amongst others 

Ras Al Khaimah, UAE: When 26-year old Rajinder Singh came rushing to the Urology Clinic of RAK Hospital complaining of excruciating right lumbar pain, a detailed investigation revealed multiple stones in the mid and lower pole of the right kidney and a large 15mm stone in the renal pelvis.

Even though the patient was suffering from the pain for the last 8 months, the situation became critical as the stones increased in size with the biggest one lodging itself in the renal pelvis, hindering the passing of the urine resulting in retrograde swelling, pain, and acute distress. An immediate surgery using an advanced technique was performed by Dr. Gina Torres, Consultant Urologist at RAK Hospital to relieve the patient of the unbearable pain.

Talking about the case and the use of the innovative technique, Dr. Torres says, “Management of patients with complex multiple renal stones have always remained challenging as they pose many risks during the operative procedure such as higher incidence of residual calculus (stone) and multiple tracts requirement.

Since there were multiple stones of varying sizes, the traditional operative methods won’t have helped. After assessing the situation, we chose to perform the 90-degree PCNL (Percutaneous Nephrolithotomy) in a supine position which is not used commonly in the UAE as very few surgeons understand it very well.

The position provides a great number of advantages over the previous prone and other positions and is safer for patients with obesity, restrictive lung diseases, and anatomical bone and urinary tract abnormalities. Being one of the most natural positions for patients, it allows for all patient anatomical structures to remain in natural neutral alignment allowing better drainage of the kidney while offering easier access for the surgeon and control to the anesthesiologist.”

Commenting on the occasion, Dr. Raza Siddiqui, Executive Director, RAK Hospital said, “Our hospital has always remained at the forefront of bringing new procedures to the country thus helping the community get the world-class care at their doorstep.”

“Additionally, compared to the classic lumbotomy (open surgery), PCNL is a less aggressive technique that facilitates the treatment of large and complex kidney stones. The decrease in-hospital stay, low analgesic medication and the short period of incapacity for work make this surgical technique well accepted by patients and should be the first option of treatment in such cases”, further mentioned Dr. Torres.

Elaborating on the Kidney stone complications, Dr. Torres stated, “Besides triggering symptoms such as pain, vomiting, and blood in the urine, kidney stones can cause serious medical complications if not treated in time. Complexities can include life-threatening septicemia (blood poisoning), renal scarring and damage causing permanent failure, loss of function leading to the kidney removal, bladder blockage resulting in painful urinary retention.”

Kidney stones are a common cause of blood in the urine and pain in the abdomen, flank, or groin. 1 in 20 people suffer from kidney stones at some point in their life. Even though the majority of stones do pass through the urine spontaneously, several factors do determine if the stone will pass naturally and these include the size of the person, prostate enlargement, pregnancy, and most importantly the size of the stone. While a 4 mm stone has an 80% chance of passage, a 5 mm stone only has a 20% chance. The larger stones require certain operative procedures depending on their position, size, and other associated complications.

The patient felt relieved after the procedure and started his normal activities from the next day. “I am pain-free and much relieved now as my 8-months agony ended. All thanks to RAK Hospital, Dr. Gina, and her fabulous team. Besides being a very good doctor, she is also good-natured, very kind, and compassionate. I will always remain indebted to the entire team at the hospital who provided the best care with all the comforts”, said Rajinder Singh.

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