Treating Kidney Stones: A Day with a Consultant Endourologist

Mr Ken Anson is a Consultant Urologist based in London. This is his account of a normal day treating kidney stones; one of the most painful conditions you can suffer from. 

I usually arrive around seven. I just come in and go straight upstairs to the office and catch up on the administrative side of the job. I have more management work to do than ever, and more things are always coming into my remit.

My day usually starts with a meeting to discuss patients, followed by a ward round, and then in the afternoon either theatre or clinic.

The early morning meeting is organised daily so that as a group of urologists who specialise in different fields, we can observe all of the X-Rays and speak openly about the patients that we are dealing with. This room is about the science – and robust arguments with a bit of banter thrown in.

I think you need an inquiring mind to be a great urologist. An average radiographer can look at an X-Ray and say “yes, there’s a problem with the scan” but a really great urologist can look at the problem and come up with a uniquely accurate assessment, while always considering how the particular problem could be resolved more efficiently in future. The really great urologists are keen on the academic side of things too; they will have read all of the literature to help them.

After the patient meeting, I do my ward round. The government are very keen on consultant led care, which basically means that every patient has to see a consultant on each weekday. So even though I’m not necessarily their consultant, I will go and have a chat with them to see how they are. This part of the job requires a lot of walking around. My wife made me download an app on my phone which counts how many steps I’m doing. I did 8,000 yesterday.

Then to clinic, which is eye-opening. We have thirty-one people here today who have a kidney stones related issue. Some are follow ups and some are more serious where we have to make decisions about operations.

You get all sorts of people who attend these clinics, but the reason people generally get kidney stones is because of a lack of water consumption. Who doesn’t drink enough water? We get a lot of chefs and delivery drivers in because they do jobs where drinking enough is either difficult or they have no instant access to a toilet so they’re reluctant to drink. Also, there’s a link between kidney stones and people from the sub-continent. Some people just get them randomly and there’s nothing you can do about it. We still don’t have an absolute knowledge of why kidney stones occur.

Kidney stones is the worst pain many of them have ever had. We have women who come in and say that they’ve had three natural birth children and they’d happily go through it all over again compared to having to deal with a kidney stone. They can be tiny. They can be just a speck on the X-Ray but cause immeasurable amounts of pain. Kidney stones are a life event; people remember with fear the day they had them and they really want you to tell them that they will never get them again.

I find working in this area enlightening. I also love working at St George’s – it has every department you could think of. It is not just the scale of the hospital though, it’s also the variety. You get all different kinds of people from one of the most diverse areas of the country and that makes it very interesting.

I was drawn into urology in the first place by inspirational role models. I had some really eminent teachers at medical school and that really got me into the idea of doing this for a living. It is the case for so many people in all walks of life – inspiration is crucial. Then when I started out I worked with a lot of guys who were war veterans, and that was really positive for me. I felt like I was giving something back to them.


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