Ureterorenoscopy

Advantages of Ureterorenoscopy:

• Easy breakage of hard stones
• Very safe, speedy recovery and relives prolonged pain.
• Minimal ureter injury
• No incisions
• Highly successful breakage of stone

Length Of The Surgery:

30 to 45 minutes

Diagnosis:

URS – Uteroscopic Stone Removal –  Ureterorenoscopy  is recommended after the following diagnosis tests.

• Physical exam
• Medical history.
• X-ray.
• CT scan.
• MRI scan.
• Sonogram.
• KUB.
• EKG (electrocardiogram)
• CBC (complete blood count)
• PT / PTT (blood coagulation profile)
• Comprehensive Metabolic Panel (blood chemistry profile)
• Urinalysis

Preparation:

Certain medications to be specifically avoided pre surgery:

• Avoid drinking/ eating 6-8 hours prior.
• Avoid blood thinning agents like clopidogrel/ aspirin/ warfarin.
• Avoid anti inflammatory, non- steroidals 7 to 10 days prior.
• Ensure sterile urine by a MSU- mid stream urine test.
• Get urine infections treated before this surgery.

Procedure Ureterorenoscopy:

• General anesthesia is given to the patient.
• A uteroscope which is a a small device like a basket, is inserted through urethra to ureter or via the bladder to the kindey.
• The stone is located through this device.
• If the stone is laser in size, then it is fragmented by using laser energy.
• With the uteroscope’s basket like structure, the stone is held and removed.
• Most of the times, the urologist places a ureter stent, which helps prevent swelling and infections after the surgery.

Risks:

• The URS potential risks include:
• Blood in the urine for a few days.
• Ureter perforation resulting into pain and leakage of urine.
• Migration of stone: The pressurised water which is used for clear vision may further push the stone beyong the kidney and ou of reach.

Post Surgery symptoms:

• Urine leakage.
• Occurence of blood.
• Stinging/ burning sensation.
• Pain in the operated area.

Follow-up:

It’s usually recommended that someone stays with you for the first 24 hours after surgery. This is in case you experience any symptoms that suggest there could be a problem, such as:

• 24 hour surveillance.
• Normal activity can be resumed after 2 days.
• For urine leakage, ADJ stent are recommended to be used.
• For stone migration, DJ stent is then inserted and also if required ESWL is scheduled.
• Increase water intake to 2.5 litres/ day ie 8 glasses.
• Visit doctor:
• Removal of stent 2 3 weeks after surgery.
  Emergency Follow up:
• Worsening pain in flank/ kidney
• Large amounts of blood clots in the urine.
• Difficult/ painful voiding and fully emptying the bladder.
• Fever

All above, treatments are finalized taking into consideration the overall health, severity, age and other ailments of the patient. Only a well experienced urologist should perform the above treatment.