Ureteroscopy (URS) kidney stone

What Is Ureteroscopy? 

                    Ureteroscopy procedure 

Ureteroscopy is a surgical procedure in which surgeon examine ureter & remove ureter  stone & polyp, tumour or abnormal tissue  by ureteroscope  its attached with high resolution camera and high intensity of light source and image displayed on screen.

During ureteroscopy, surgeon   inserts a thin scope into patient urethra and then bladder and then ureter (ureter is tube or pipe like structure which collect urine from kidney). 

                         Kidney stone 

Kidney stones are pebble-like objects (but not real stones) made of minerals and salts found in urine. They form in a kidney, but can move down the ureter.

Preparation before the operations:

Take a shower the night before surgery or the same morning. Your surgeon might ask you to use an antibiotic soap. 

Nill by mouth(NBM):

Stop eating and drinking at the time your doctor tells you before surgery.

The morning of your surgery, you may take medications your doctor told you are allowed. Take them with just a sip of water.

Blood test and chest - xray for physical fitness for surgery and all tests are prescribed by urosurgeon.

Some other important preparation:

Patient  might need to stop taking certain medicines before surgery. These include blood thinners, supplements, and medicines that affect your immune system. Talk to your surgeon when patient schedule Ureteroscopy.

Patient  will need someone to drive you home from surgery.  You will also need someone to stay with you overnight. Ask your doctor or nurse how much help you might need.

Anesthesia :

General anesthesia ( patient asleep during whole surgery ) or spinal anesthesia ( no sensation and no pain feel below the abdomen during surgery ) gives to patient its depends on surgeons choice and also depends on patient physical condition.(any past surgery or past long term disease).

Procedure :

This procedure performed in operation theatre sterile area with all sterile instruments and equipments. Once ureteroscope is in the bladder,urologist filled bladder  a sterile water solution through the tip of the ureteroscope for clearly vision then gently introduce the ureteroscope into a urethra than ureter. Once stone is found than stone crushed and break into small pieces with the help of laser "Holmium laser ".  A similar procedure uses a tiny basket at the end of the scope to hold and remove a stone.

If there is a concern about a kidney, the scope can be moved all the way up into that organ and all fluid out emptied bladder. 

             View of ureter stone on screen 

Stent: stent is also put inside the ureter for urine and infectious fluid, drain out fluid and prevent for infection because very old stone make infection and pus formation inside the kidney and ureter that conditions stent is necessary but some its not necessary.

                     View of fluoroscopy 

Folleys and urobag= folleys catheter also inserted for urine output for 1-2 days

Duration of surgery = approximately 1hour. 

Symptoms of ureter stones=

1.Pain in pelvic region.

2.Pain & burning sensation during the urination.

3.Hematuria (blood in urine).

4.Blockage in ureter due to stone and polyp and abnormal tissue or ployp.

5.UTI ( urine infection )

6.Swelling at the abdomen due to incontinence of urine.

How to dignose and identified :

Urine test to diagnose possible infections.

CT scan to diagnose kidney stones and identify their size and location.

MRI to provide detailed images of your kidneys, bladder, and other internal organs.

Benefits and Risks with Ureteroscopy:

Ureteroscopy is an effective way to do several things. For example, it lets your urologist:

1.Get a very clear view of the urinary tract.

2.Remove or break up stones easily and fast recovery.

3.Take out suspicious-looking tissue.

complications :

ureteroscopy include a slight chance of bleeding or injury to the ureter. As with many medical procedures, there is a small chance of infection.

After the procedure Of Ureteroscopy:

1.Burn sensation while urinating.

2.Small amount of blood in urine because of surgery.

3.Abdominal pains

What do after the procedure :

1.Drink about 1 litre of water over the two hours

2.Taking warm bath. 

3.Taking antibiotics for few days prevents from infection 

4.Taking painkiller to reduce pain.

 5.place a warm, damp washcloth to relieve burning urination.

6.chills or fever, tell your doctor. This could mean you have an infection.

Sample for laboratory :

If a piece of tissue was removed for a biopsy, you may have to wait a few days for lab results..

Remark :most important things drink a lots of water to prevents infection and prevents recurrens of stone formation.

For know more details & appointment contact us : 

+91 7692976910

DR. VIMAL KESWANI

MBBS, MS, DNB Urologist & andrologist, Mumbai

Consultant urosurgeon 

Former consultant at R.G. stone hospital, mumbai