Patients suffering from kidney, ureter or gallbladder stones have been facing problems getting appointments for lithotripsy, a non-invasive procedure involving the physical destruction of hardened substances like kidney stones, bezoars or gallstones.
Four teaching hospitals- Mayo Hospital, Jinnah Hospital Lahore (JHL), Services Hospital and Lahore General Hospital- have the lithotripsy apparatus, but only the one at the LGH is in working condition.
A urologist at the LGH told The Express Tribune that the shortage of working lithotripsy apparatus had made it hard for patients to get an appointment. “A patient needing immediate surgery, who visits the LGH, may have to wait for an appointment till mid-2014. That’s how long the waiting list is,” he said. “Doctors sometimes have to conduct the surgery in less than the prescribed time just so they can accommodate more patients.”
A senior surgeon at Mayo Hospital said the lithotripsy apparatus at three hospitals were out of order because its coils had completed design working life and needed to be replaced. “A coil costs Rs5 million to replace. It lasts for three years,” he said. “The machines have been out of order for months now. The patients we treat with these machines are typically in acute pain.”
Pakistan Association of Urologic Surgeons General Secretary Safdar Faldhera said, “Lithotripsy is expensive. Since the apparatus at public hospitals is better than in most private hospitals, their maintenance cost is higher as well. The apparatus available at public hospitals costs Rs30 million. The one used in private setups costs around Rs1.7 million.”“The apparatus in public hospitals makes the procedure easier for doctors and patients. If I was trying to break a stone that was 2 centimetres in diameter all I had to do was focus on one corner of it and decide which part to break first. This facility may not be available on machines at private hospitals,” he said.
Furthermore, patients at private hospitals are charged Rs30,000 to Rs50,000 for removal of a single stone…the procedure is free at public hospitals.
A urologist at JHL said they had had to schedule appointments for June/July next year. “Without lithotripsy, surgeons have to conduct open surgeries that not only overburden doctors, but also increase the cost of healthcare for patients. Open surgery has many hazards and complications. The government can do us a great service if it just fixes the lithotripsy machines in three hospitals,” he said.
“Most kidney stone patients hail from Okara, Pattoki, Kasur, Hafizabad, Depalpur and Hujra Shah Muqeem. Around 150 kidney patients visit the Outpatient Department (OPD) at Jinnah Hospital. Half of them suffer from stones in their kidneys or ureters and 80 per cent of them can be treated through lithotripsy,” the doctor said. “Some people don’t want these machines to become operational so that they can earn more money in their private setups,” he alleged.
A Health Department spokesman said instead of informing media, doctors should directly write to the Health Department.
He said, “I cannot give a timeframe for when these machines would.
Published in The Express Tribune, December 21st, 2013.