UAE: Doctors remove nearly 200 stones from Pakistani expat's kidney

A Pakistani national, Mian Khan, suffered from excruciating pain for the past four years of his life due to kidney stones.

The Dubai resident finally approached doctors at a UAE hospital for treatment as the suffering affected his life. The collaborative work between a urologist and an Intervention Cardiologist at Burjeel Specialty Hospital, Sharjah, extracted nearly 200 stones from his kidney.

Dr Vaibhav A Gorde, a Specialist Urologist at Burjeel Specialty Hospital, Sharjah, diagnosed Khan with staghorn calculus, a condition in which large renal stone branches out in the entire kidney. The doctors recommended the Percutaneous Nephrolithotomy (PCNL) procedure performed on patients with kidney stones resistant to other forms of treatment. Through this procedure, Dr Gorde could remove the stones and save the patient's kidney.

Complex procedure

"While PCNL is a common procedure, it became a skilful and time-consuming surgery in Khan's case. I removed as many as 200 stones through a small keyhole in his back, including a large stone of 36mm x 41 mm. The patient recovered well within three days of the surgery and was sent home," says Dr Gorde.

After eight days, Khan had trouble passing urine and returned to the hospital. Further investigations revealed a large clot in the bladder. After removing the clot, the doctors diagnosed Khan with possible bleeding from a blood vessel in the kidney.

This rare recovery complication occurs in 0.6-1 per cent of cases with only two options. "One involves emergency Nephrectomy (removal of the kidney). The second is a kidney-saving option called angioembolisation which involves very selectively stopping the bleed from vessels of hardly 1mm size," said Dr Gorde.

"It is a demanding and highly skilled procedure. We had a team ready to perform the second procedure," said Dr Gorde, who quickly shifted Khan to the Cath Lab, where the cardiology team was waiting to take over.

Dr Rahul Chaudhary, a specialist interventional cardiologist at the hospital, performed the super-selective angioembolisation procedure on Khan. The doctor inserted a catheter through a small puncture of around 2 mm and passed in a wire to selectively access the tiniest branch that was the source of the bleed.

"The blood vessel that supplies the kidney is like a tree with many branches that makes selecting the bleeder highly complex. If we get close to any other blood vessel, that particular portion of the kidney can get damaged," said Dr Chaudhary.

ayaz@khaleejtimes.com