Advanced tubeless kidney stone surgery now routine at BMU

Bangladesh Medical University (BMU) is now routinely performing Total Tubeless Mini-Percutaneous Nephrolithotomy (Mini-PCNL), an advanced minimally invasive procedure for removing kidney stones that reduces treatment costs, shortens hospital stays and speeds up recovery.

The procedure is being carried out regularly by a team of urologists led by Prof Dr Rafiqul Islam at the university’s Department of Urology.

Prof Rafiqul Islam said the surgery is not only cost-effective but also allows patients to return home within 48 hours, making it a more convenient alternative to conventional procedures.

“This is a low-cost procedure. Patients can usually be discharged within 48 hours of surgery. Although the operation is still performed only rarely outside BMU, we are now carrying it out regularly to ensure quicker recovery with minimal suffering,” he told the Daily Sun.

During a recent visit to Ward 4B of the Department of Urology, this correspondent met Haleema Khatun from Tangail, who was admitted to the hospital on 9 July after suffering from severe lower abdominal pain.

"I first went to a local hospital in my district, where doctors referred me to BMU. After several tests, doctors diagnosed a kidney stone and removed it through surgery. I was worried about the surgery and possible complications, but I never imagined the stone could be removed so easily," she said.

Dr Nahid Hasan Rifat, a medical officer at the Department of Urology, said Haleema had been diagnosed with a stone in her right kidney.

“We receive patients with various kidney diseases, but kidney stone cases are among the most common,” he said.

He said the department, under the leadership of Prof Rafiqul Islam, had made Mini-PCNL a routine procedure to reduce treatment costs and patients' suffering. The procedure, which was performed only occasionally at BMU in the past, is now carried out every week.

According to Dr Rifat, the operation costs more than Tk100,000 at many private hospitals, while the same procedure is available at BMU for around Tk10,000 to Tk12,000.

Medical experts describe Mini-PCNL as a minimally invasive keyhole procedure used to remove medium-sized and large kidney stones through a small incision, usually measuring one centimetre or less, in the patient's back. Compared with conventional open surgery and standard PCNL, the procedure causes less bleeding and pain and enables faster recovery.

Explaining the Total Tubeless Mini-PCNL technique, Prof Rafiqul Islam said the procedure eliminates the need for drainage tubes and stitches after surgery.

“The patient does not need to stay in hospital for a long time. Kidney stones are removed using a very small instrument, and most patients can return home within two days,” he said.

He explained that conventional PCNL often requires a drainage tube to be inserted into the kidney after surgery. The tube must later be removed in another operation, requiring the patient to return to hospital after four to six weeks.

“In the Total Tubeless Mini-PCNL procedure, no drainage tube or stitches are required after surgery. This reduces the risk of infection and saves patients from undergoing another operation to remove the tube,” he said.

“I introduced this procedure after considering the suffering patients go through. Our aim is to provide treatment that allows people to recover quickly, reduces their pain and minimises the need for repeated hospital visits,” he added.

He also said the choice of treatment depends on the size and location of the kidney stone.

“It is not reasonable to perform a large incision for a small stone. That is why minimally invasive procedures such as Mini-PCNL have become an important standard treatment option,” he said.

According to the Institute for Health Metrics and Evaluation (IHME) at the University of Washington, more than 12.9 million people in Bangladesh are living with kidney disease.

The institute estimates that around 17,000 people die from kidney-related illnesses in the country every year. Kidney diseases include chronic kidney disease linked to diabetes and hypertension, kidney stones, kidney cancer, urinary tract disorders, kidney inflammation and acute kidney injury.

A recent survey also found that kidney disease is the second leading reason for Bangladeshis seeking medical treatment abroad after heart disease. While 29.8% of overseas medical travellers seek treatment for heart conditions, 17.3% travel abroad for kdney-related care.