Ureteroscopy

What is it?

 

A telescopic examination of the bladder followed by examination of the ureter (the tube joining the bladder and kidney) using another telescope.  If a stone is seen, it will be broken into small pieces, and removed using a fragmentation machine (lithoclast).  A special tube called a stent may be placed in the ureter to prevent it form blocking after the procedure.  The stent will be removed later once any swelling has gone down.

 

Before the cystoscopy

 

You will be told when to stop eating and drinking prior to the procedure.  You should discuss with Dr Bourne before the procedure if you have any allergies or any medication you are taking, particularly if Aspirin / Arthritis medication or Warfarin.

 

General Risks

  • Small areas of the lungs may collapse, increasing the risk of chest infection.  This may need antibiotics and physiotherapy.
  • Clots in the legs (deep vein thrombosis or DVT) with pain and swelling.  Rarely part of this clot may break off and go t the lungs which can be fatal.
  • A heart attack because of strain on the heart or a stroke.
  • Death is possible due to the procedure.

Risks or this Procedure

  • Rarely damage to the urethra – the passage which brings the urine out of the bladder.  A false passage may be produced causing leakage of urine or in the long term, a stricture that may affect flow of urine.
  • Damage to the bladder with perforation of the bladder.  This may need further surgery.
  • Swelling at the exit of the bladder which may result in urine retention. A tube (catheter) may need to be put in place to drain the urine until the swelling goes down.
  • Bacteria may get into the blood stream with the development of septicaemia.  Further treatment with antibiotics may be required.
  • Bleeding which may stain the urine colour and sometimes cause blockage of urine flow.
  • Burning and scalding of urine for a few days after the procedure.  This usually settles.
  • The catheter may not be able to be passes through the ureteric opening and up to the kidney because of a blockage.
  • Rarely, damage to ureter (hole or disrupted) a stricture may form.  Very rarely an open operation may be required to repair the damage.
  • Increased risk in obese people of wound infection, chest infection, heart and lung complications and thrombosis.
  • Increased risk in smokers of wound and chest infections, heart and lung complications and thrombosis.
  • The stone may not be removed completely.

Please notify us or present to the hospital if:

  • bleeding persists
  • high temperature develops
  • bladder irritation continues
  • severe abdominal pain

Stop the following TWO WEEKS prior to admission:-

 

  • Action
  • Aggrastat
  • Alka-Seltzer
  • Any Aspirins
  • Arixtra
  • Asasantin
  • Aspalgin
  • Aspirina
  • Aspro Clear
  • Aspro Tabs & Capsules
  • Astrix
  • Bayer Aspirin
  • Bex tablets & Powders
  • Cartia
  • Cardiprin
  • Codiphen Forte
  • Codis Morphalgin
  • Codral Forte
  • Codox
  • Decrin Powder
  • Disprin
  • Disprin Forte
  • Ecotrin
  • Iscover
  • Persantin
  • Plavix
  • Solcode
  • Solprin
  • Spren
  • Veganin
  • Vincents Tabs & Powders
  • Winsprin

 

Stop the following SEVEN DAYS prior to admission:-


Anti-inflammatory drugs:

 

  • Acliln
  • ACT-3
  • Actriprofen
  • Arthrexin
  • Brufen
  • Butazolidin
  • Celebrix
  • Clinoril
  • Clunisol
  • Declofenac
  • Diflunisal
  • Dolobid
  • Fledene
  • Feldene-D
  • Fenac
  • Ibuprofen
  • Indocid
  • Indomed
  • Indomethacin
  • Inza
  • Ketoprofen
  • Ketoralac
  • Mefenemix Acid
  • Mefic
  • Mobilis
  • Mobilis-D
  • Naprogesic
  • Naprosyn
  • Naproxen
  • Nurofen
  • Orudis
  • Oruvail
  • Phenylbutazone
  • Piroxicam
  • Ponstan
  • Proxen
  • Rafen
  • Sulindac
  • Surgam
  • Tenoxicam
  • Tiaprofenic Acid
  • Tilcotil
  • Toradol
  • Voltaren
  • Vioxx

 

ANTICOAGULANTS

 

If you are taking MAREVAN, DINDEVAN OR WARFARIN, TICLID, TICLOPIDINE, COUMADIN take half dose for ONE day, FIVE days before the operation, then stop the tablets FIVE days before the operation. Discuss this with your Physician, as some patient Need Heparin injections when they cease taking these tablets. The tablets should not be resumed until TWO weeks after the operation, unless otherwise advised by your Physician or Surgeon.

 

Panadol, Panadeine or Digesic may be taken for pain relief.

 

PLEASE ENSURE DOCTOR IS AWARE OF ALL DRUGS, PILLS, MEDICATIONS ON OR OFF PRESCRIPTION THAT YOU TAKE, EVEN IF THEY ARE NOT ON THE ABOVE LIST.