Endourology and minimally invasive urological surgery

Endourology is the sub-speciality of urology concerned with the investigation and treatment of urological symptoms and diseases using closed or minimally invasive surgical techniques. This involves passing highly specialised instruments through the urological tract or keyhole surgery through the abdomen for the treatment of kidney stones, tumours, and a wide range of other diseases of the kidneys, ureters, bladder, prostate or urethra.

Kidney stones can often be treated by shock wave lithotripsy (ESWL) without the need for invasive surgery, and we have access to the best lithotripsy service in London. Even at the best centres, however, lithotripsy can be ineffective and for these very hard stones laser surgery is recommended. This technique involves passing very small instruments through the urological tract to the stone, and fragmenting it using targeted laser energy without damaging the surrounding tissues. Sometimes stones in the kidney are too large for laser treatment, and these stones require removal through a specially made tract into the kidney through the back. This is called percutaneous nephrolithotomy.

Endourology also encompasses laparoscopic (keyhole) surgery of the kidneys and ureters. These very advanced surgical techniques allow complete or partial removal of the kidney for benign diseases or cancer, removal of very large stones impacted in the ureter, and also reconstructive procedures for conditions such as pelviureteric junction (PUJ) obstruction in the form of laparoscopic pyeloplasty, and combined laparoscopic stone removal and pyeloplasty.