Ureteroscopy (URS)

What is Ureteroscopy (URS)?

Ureteroscopy is a procedure used to find and treat problems associated with the urinary tract by inserting a flexible instrument called a scope through the urinary bladder and ureter (the tube that connects the kidney and bladder).

In the case of ureteral stones, it allows the surgeon to look for them and remove them in certain cases. Lasers or lithotripsy can be used to break the stone down into finer fragments.

People who suffer from pain due to urinary problems may be advised to undergo Ureteroscopy, commonly those who have lower ureteral stones.

Kidney stones are most likely to be treated using shock wave Lithotripsy (SWL). However, this may not be suitable for everyone. 

For very large, harder stones, alternate other treatments such as percutaneous nephrolithotomy or open surgery may be required.

How to prepare for surgery?

You will need to undergo a full body examination including tests like blood and urine analysis before the procedure.

You will need to pee before the procedure as directed by the doctor or nurse. You should follow the instructions regarding eating, drinking, and taking medicines before the surgery as instructed by the doctor. 

The dosage of certain medicines needs to be altered before the surgery. Discuss this with your doctor in case you are taking any medicines on a routine basis.

How is Ureteroscopy (URS) performed?

The surgeon performs this surgery under general anesthesia.  

A scope is inserted from the tip of the urethra via the ureters to look for abnormal tissue or stones. A sterile solution is flushed through the scope which enables better visualization within the bladder. 

The procedure may last for around 30 minutes. If during the same session the doctor intends to break the stone down or take a tissue sample for biopsy, the surgery may last longer.

During this procedure, the doctor may typically use a Holmium laser to fragment the kidney stones and use a small wire basket to remove these pieces.

What is the post surgery care to be taken?

You will be taken to the recovery room after the surgery for the anesthesia to wear off which may take 2 to 4 hours. 

The patient usually can leave the same day after the procedure. You should have someone to take you home after the surgery.

Sometimes the doctor may insert a stent to help you pass urine more easily after the surgery. You will need to drink plenty of water later to flush out the bladder for the next two hours.

You may notice some blood while peeing in the next 24 hours which is normal accompanied by mild pain or discomfort in rare cases.

You will be prescribed painkillers and antibiotics to help you manage pain if any and prevent infection. 

You may be advised to take a warm bath or place a warm, damp washcloth over the opening of your urethra to ease any discomfort if present.

You must report to the doctor immediately on noticing the following sign and symptoms:

  • Extreme pain that does not fade even on taking medicines.

  • High fever or chills

  • Fluid drainage at the operated site with a foul odour or any such unusual signs.

What are the benefits of Ureteroscopy surgery?

It is a conservative surgical treatment option.

  • It helps to remove kidney stones in the ureter which are made of minerals and salts. It helps to relieve pain and other symptoms associated with it.

  • A urologist may also suggest this procedure for confirming a diagnosis in those who may be suffering from a tumour, polyp, or abnormal tissue in the urinary tract.

  • The stone, polyp, tumour, or abnormal tissue removed is sent to the pathologist for a biopsy and further lab tests.

What are the risks of Ureteroscopy surgery?

The potential complications of Ureteroscopy include:

  • Excessive bleeding

  • Stent pain

  • Ureteral stricture and avulsion

  • Injury to the ureter.

  • Chance of infection.

  • Discomfort and pain while peeing after the procedure.

  • Complications related to General anesthesia during the procedure.

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