Ureteroscopy is an outpatient surgical procedure that is chiefly done to treat or remove kidney stones from the ureters (the tubes that connect your bladder to your kidneys) or kidney. It is a type of Kidney Stone Surgery that is usually done using an instrument called ureteroscope (a long, thin tube that has an eyepiece on one end and a tiny lens and a light on the other end). This procedure also helps to evaluate and treat other causes of kidney blockage or blood in your urine.
Kidney And Its Functions
Our kidneys are two bean-shaped organs in the renal system. They are extremely essential for the body as it helps the body pass waste as urine. Right from maintaining overall fluid balance (i.e., osmolarity, ion and pH balance), regulating and filtering minerals from blood, controlling blood pressure, making red blood cells, keeping the bones healthy, filtering waste materials from food, medications, and toxic substances and creating hormones that help produce red blood cells, promote bone health, and regulate blood pressure, the kidneys do it all.
What Are Kidney Stones?
Kidney stones are pebble-like objects made of hard deposits of minerals and acid salts that stick together in concentrated urine. They form in a kidney, but can move down the ureter. They can be quite painful when passing through the urinary tract, but usually don't cause permanent damage. The most common symptom of kidney stones is severe pain, usually in the side of the abdomen, that's often associated with nausea and vomiting, blood in the urine, cloudy or smelly urine, pain or burning urination and sometimes even fever accompanied by chills.
What Is The Purpose Of A Ureteroscopy?
A ureteroscopy is usually advised by a doctor or health care provider for those patients who are experiencing extreme pain while urinating, have traces of blood in the urine, blockage in the kidney due to stones or suspect a polyp, tumor or abnormal tissue somewhere in your urinary tract. It is also helpful as part of shock wave lithotripsy, a treatment to break up kidney stones for some special cases like women who are pregnant, people suffering from blood clotting problems or for individuals who are obese in nature.
Ureteroscopy is also beneficial for to check for cancer, examine portions of the ureter that might have become narrow, diagnose urinary tract infections and other problems related to urinary bladder.
How To Prepare For A Ureteroscopy?
Before proceeding for the procedure, you must disclose what medications you are taking, including over the counter ones. You must also tell your doctor about any current health condition including pregnancy.
The doctor usually asks the patient to not eat anything after the midnight prior to the procedure and temporarily stop taking medicines like blood thinners but not prescription ones. The doctor may also ask the patient to give a urine sample before the procedure to check for urinary tract infections, in that case you may be instructed not to urinate for an hour before the procedure.
What Is The Procedure Of Ureteroscopy?
After injecting anesthesia, once it takes effect and you are asleep, the specialized doctor or urologist inserts the tip of the ureteroscope into the urethra (the tube through which urine passes out of your body). Once the ureteroscope is in the bladder, the doctor releases a sterile liquid through the tube to help see the walls of the urethra clearly. The ureteroscope is then slowly inserted into the ureter or all the way up in the kidney if there is a problem in the organ. It chiefly takes close to 30 minutes to visualize the urinary tract or the ureter to look for any problems. In case the procedure is done to remove or break up a stone, or to take a tissue sample for a biopsy, the ureteroscopy may take longer.
In general, there are two ways to perform ureteroscopy for stones:
If the stone is small, the urologist will insert a scope into the ureter to remove the stone. The type of scope used in this case will have a small basket attached at the end of a wire that is run through an extra channel in the ureteroscope. The basket is mainly used to collect the broken stone.
If the stone is larger in size, the urologist will chiefly extend a flexible fiber through the scope up to the stone. With the help of a laser beam shining through the scope, the healthcare provider will break the stone into pieces small enough to be passed out of the body with urine. The type of laser used with the ureteroscope is called a “Holmium laser.” This process may take up to 90 minutes.
What Happens After Ureteroscopy?
After the ureteroscope is lodged out of the urethra and the fluid is emptied, you will slowly recover while coming out of the anesthetic effect which generally takes upto 3-4 hours. Being an outpatient procedure, you can go back home but the doctor suggests to arrange for a ride home since there might still be a lingering effect of the anesthesia. The doctor may place a stent (a small tube to offer support) to help the kidney heal and repair which may cause a little discomfort for a few days until it is removed.
The doctor also asks the patient to strictly follow certain instructions which includes:
Take adequate rest for at least 24 hours.
Take prescribed pain medicine and antibiotic to prevent infection
Drink 4 to 6 glasses of water a day to dilute your urine and help flush out the urinary tract.
It is normal to see blood in the urine for several days and even experience mild pain in the bladder and burning while urination after the procedure.
The doctor may also suggest sitting in a warm bath or apply a warm, damp washcloth over the urethral opening to subside pain and relieve discomfort. You can even use ice packs or heating pads to subdue the pain.
What Are The Risks Associated With Ureteroscopy?
Although this invasive procedure does not pose any threat if done properly. But in certain cases, it may cause infection, bleeding and injury to the ureter. There is a bleak risk (one in 1000) of a major injury that could require an extensive surgery to repair. In case of placement of stent, there might be a little pain and discomfort while urinating for a few days until it is removed.