A state-of-the-art new treatment for kidney stones

Written by: Mr Andrew Ballaro
Edited by: Top Doctors®

A new technique for the removal of kidney stones is now being used in the UK at select hospitals. The ultra-mini percutaneous nephrolithotomy (UMP/ultra-mini PCNL) is a minimally-invasive technique which can be used to treat large, complex, or multiple stones. Consultant urologist Mr Andrew Ballaro now regularly performs the procedure both in his NHS and private practice as a day-case procedure. Here he explains how the procedure is performed, and what benefits it can bring to the patient.  

What is ultra-mini PCNL?

Ultra-mini percutaneous nephrolithotomy (UMP) was developed in India and has recently been brought to the UK. Developed using new technology, and with patient recovery time in mind, it involves the insertion of a fine tube into the kidney through a 3mm incision in the skin of the back. A laser is then used to fragment the stone, and the fragments are washed out through the tube using a special irrigation system. This enables even quite large stones to be removed safely, completely and efficiently without needing to dilate the ureter (tube draining urine from the kidney to the bladder) or to leave a ureteric stent, which can very uncomfortable. 

What are the benefits of ultra-mini PCNL?

  • Ultra-mini PCNL significantly reduces blood loss (meaning there is less need of blood transfusion), the risk of damaging kidney blood vessels, and the post-operative length of stay compared to standard procedures.
  • UMP avoids the need for uncomfortable ureteric stents (a thin tube inserted into the ureter to prevent or help treat obstruction of urine flow).
  • There is less recovery time with this procedure; Mr Ballaro performs the UMP as a day case.
  • People go back to normal activity more quickly.

Who is a candidate for the ultra-mini PCNL procedure?

Any patient with a significant sized kidney stone. The procedure may be recommended in those who have large kidney stones, especially in the ureter, or kidney stones which block more than one branch of the collecting duct system in the kidney.

You can book an appointment to discuss the UMP/ultra-mini PCNL procedure with Mr Ballaro here

By Mr Andrew Ballaro

Mr Andrew Ballaro is a highly experienced NHS and private consultant urologist, specialising in the diagnosis and treatment of all urology problems, including kidney stones, blood in urine, urinary infections, prostatitis, prostate and bladder problems, and urological cancers. He has a particular interest in the comprehensive management of urinary stone disease and benign prostate hyperplasia (BPH). He consistently publishes leading results for complex stone operations and offers all treatments including mini and ultra-mini PCNL for kidney stones. He also offers a choice of surgical procedures for benign prostatic disease including Holmium Laser prostatectomy (HOLEP) the new Rezum steam treatment and MRI targeted template prostate biopsy. He has a doctoral research degree in the overactive bladder and sees many patients with this condition. He holds clinics on Wednesdays and Fridays at The Wellington Hospital and The Hospital of St John and Elizabeth in North London and also consults at locations in Essex.

Mr Ballaro's extensive training began after graduating from The Royal Free Hospital Medical School in London, and undertaking his basic surgical training at Oxford. He was awarded a Fellowship from the Royal College of Surgeons of London and went on to complete higher urological training on the North London Training Scheme. This was followed by advanced training in laparoscopy and complex stone surgery from national and international experts in his field.

Mr Ballaro has a strong interest in education, currently teaching trainees at the London Deanery across many levels, in addition to being awarded a Hunterian Professorship from the Royal College of Surgeons of England. He holds a Masters degree in Urology and an MD in Clinical Sciences from the Institute of Urology and has published extensively on the subject of minimally invasive urological surgery. He is the co-author of the latest edition of the popular medical student textbook 'Lecture Notes in Urology'.

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