DHB trials device for kidney stones

A laser device used to treat kidney stones could slash waiting times and relieve patients' distress if it is purchased by the Northland District Health Board.
The state-of-the-art, portable medical device called a lithotripter, or stone breaker, is one of two which have been going through clinical trials on patients at the Whangarei Hospital since mid last year.
A decision on whether to purchase one will be based on clinical evidence, and at the board's discretion, after the trial.
The 91 cases on the urology surgical bookings list as of December 2008 include several that have kidney stones.
From that number, 79 are routine, 10 semi-urgent and two urgent cases.
They could be treated either by Mobile Surgical Services, operated on at the hospital or with the use of the trialled device if it is purchased.
The device costs between $450,000 and $800,000 and has a laser which is passed into parts of the urinary tract, which fragments the stones.
Whangarei Hospital's urology services currently utilise an ultrasound lithotripter and electro-kinetic lithotripter for the treatment of stones that require invasive or urgent treatment.
Non-invasive stone treatment is conducted by health board-funded Mobile Surgical Services which visits Northland about 10 times a year.
"In general, when Northland DHB considers purchasing equipment for new medical procedures, as part of the procurement process equipment certification, trials and staff training are also required," board general manager clinical services Nick Chamberlain said.
He declined to discuss the details of each trial, saying it would unreasonably prejudice its commercial position.
Board public relations manager Fleur King said about 38 invasive treatments of kidney stones were done each year.
She said more people could be treated and at a faster rate if the new device proved successful and the board decided to purchase it.
Whangarei Hospital currently has a urologist and a locum, with another urologist expected to start next month.
• Kidney stones (also called renal calculi) occur when substances within the urine precipitate and form solid material.
• The stones can vary in size from a grain of sand to bigger than a golf ball and can cause severe pain.
• They can be smooth, have jagged edges and consist of a single stone or many stones.
• Small kidney stones can cause pain as they pass through the urinary tract. Large stones can become stuck in the kidney, ureter or bladder causing pain and blocking urine flow.
• This can lead to infection and kidney damage.
• Five to 10 per cent of New Zealanders are affected by kidney stones.
• They are more common in men and occur more commonly in older people than in youths.
* Waiting game an agony for patients
Northland's Jim Boyd was diagnosed with stones in his kidney. He has had four episodes of pain which ended up partially rupturing his kidney.
He is one of dozens of Northlanders with the painful stones hoping a clinical trial of a new laser device at Whangarei Hospital proves successful.
The former policeman, now living in Kerikeri, spent two days before Christmas in Whangarei Hospital and is among those waiting to be seen by a urologist since May 2008.
Mr Boyd was first diagnosed with kidney stones in the United States in April 2008, while attending a symposium on animal and vet forensics. Since then, he has been on medication and on a waiting list.
On his last visit to Whangarei Hospital just before Christmas Day, he was prescribed painkillers and morphine. He said a lot of people like him could be spared the pain and hospital time by the laser device.
"The machine, as I understand, could lower the workload of urologists and free some hospital beds and the risks associated with it," he said.
"We live in a world of modern technology and this machine really should be used for the betterment of the public because we are not supposed to be a third world country.
"My concern is the time me and others are having to endure before getting seen, the level of pain involved and eventually getting treated with the minimal of staff. I think the latest technology will be of great benefit because a lot more patients will get treated this way instead of being operated on."