What does the procedure involve?
Ureteroscopy involves the insertion of a small caliber telescope into the ureter (the tube that connects the kidney to the bladder) via the bladder. It is usually performed under X-ray guidance. The entire length of the ureter, as well as the kidney can be inspected.
It allows the treatment of stones, strictures (narrow scarred areas) and tumours. The laser treatment of stones is the most common procedure performed using this technique.
Depending on your exact needs the ureteroscope (or pyeloscope) used may be flexible or semi-rigid.
What happens during the procedure?
Usually you will be given a light general anaesthetic (you will be asleep) during the procedure. The anaesthetist will discuss this with you prior to commencement. You will also usually receive some covering antibiotics.
A cystoscope will be inserted into the bladder via the urethra (the tube through which you pass urine). Under X-ray guidance, a flexible guidewire will inserted into the affected ureter up to the kidney – this is often referred to as a “safety wire”.
A longer finer telescope (ureteroscope) will then be inserted beside the wire and passed up to the kidney to locate the stone(s). The stone(s) will be disintegrated using laser energy. The fragments will then be extracted using special retrieval baskets.
A ureteric stent is often left in place, after the procedure, which will need to be removed a few weeks later. Occasionally a bladder catheter is inserted.
What happens after the procedure?
You will usually go home the same day as your surgery.
For a few days after your procedure, it is normal to experience any of the following:
A mild burning when you pass your urine.
A need to pass urine more frequently, and occasionally more urgently than you usually do.
Some blood in the urine.
All usually settle quite rapidly without the need for any treatment.
What can you do to help?
Drink plenty of water.
Take Ural or Citravescent in a glass of water 4 times a day.
2 Panadol every 4 hours.
Take any antibiotics you have been prescribed.
Are there any side effects?
Most procedures are straightforward but as with any operation there are potential complications and side effects.
Mild burning or bleeding on passing urine for short period after operation.
Insertion of a stent with a further procedure to remove it.
The stent may cause discomfort, the need to pass urine more frequently than normal and bleeding in the urine.
It may not be possible to retrieve some or all of the stone(s) and the operation may need to be repeated on another occasion.
Displacement of the stone into an inaccessible site in the kidney.
Infection needing further treatment.
Failure to pass the telescope if the ureter is narrow.
Very rarely, scarring or stricture of the ureter needing further procedures.