“Women will often say ‘I’d rather go through labour than kidney stone pain’, so that gives you some idea of the intensity of it,” says Mr Shalom Srirangam, a consultant urologist at East Lancashire Hospitals NHS Trust.
If the stone is small, then it will pass through in the urine and only painkillers are necessary. However, in other cases surgery might be needed.
The Urology Foundation funded Shalom to study the impact of stone disease and its treatment on patients, particularly how it affects their quality of life once they leave the hospital.
“We just don't know what happens to them when they go home,” he says. “Most of the data comes from outside the UK. It’s often from America and their system is very different.”
The study was small, with only 30 people completing all of the questionnaires out of the 89 who signed up to take part.
“We have small numbers, but it just gives us a snapshot into what is clearly a bigger problem that we've just not captured very well yet,” says Shalom.
One surprising result was that each patient had on average another 3.4 unplanned visits to healthcare professionals for the same kidney stones after first diagnosis.
“We also demonstrated that if you definitively deal with the stone the first time the patient presents themselves, then they tend to recover a lot quicker. If you dealt with a stone straight away, it was about 9 days’ sick leave as opposed to an average of 35 days,” says Shalom.
One of the challenges, Shalom says, for dealing with the patients straightaway is the lack of infrastructure, expertise and personnel to be able to deal with all acute stones at the time of presentation. “Something needs to be done about the infrastructure and the flexibility of the system to deal with these patients as an emergency.”
Shalom is planning to use what he has learnt from the small study to make it easier for patients to respond to the questionnaires in a future multi-sentre larger study.
“Ultimately, this study was always going to be the first step towards something bigger to be able to help answer this,” he says.
“I truly am grateful to TUF. I needed that funding to get the project off the ground. The funding helped to support patient involvement in the design of the project, recruiting participants and sending them the questionnaires. Thanks to the funding from TUF, the project was adopted on the NIHR portfolio and became eligible for nursing support and access to expertise from the Clinical Research Network."
