Ureteroscopy & Stone Destruction and Stent Insertion
What is it?
Ureteroscopy is a procedure where a fine telescope (ureteroscope) is passed through the urethra and bladder and up the ureter towards the kidney. Ureteroscopy is used to treat and view the ureter, which is the narrow part which joins the kidney to the bladder.
Why is it done?
Ureteroscopy is used to treat and remove stones lodged in the ureter. If you have had a ureteric stent (tube which runs from the kidney to the bladder) inserted previously, the stent may be removed at the same time once the stone is successfully removed during the procedure. You may require a second procedure if your stone is not successfully removed (this is usually performed a few weeks later). This is usually due to the size of the stone and ureter (large stone + narrow ureter). If this occurs, your surgeon will insert a ureteric stent as a temporary measure to relieve the blockage and back pressure on the kidney. Ureteric stents are soft flexible tubes which run from the kidney to the bladder. The stent also causes the ureter to expand – making it is easier for the surgeon to remove the stone during the second procedure a few weeks later.
How is it done?
This procedure is done under a general anaesthetic. The procedure is performed through the urethra (urinary passage). The surgeon passes a telescope (cystoscope) through the urethra to the bladder. A very fine wire is then passed up the ureter all the way to the kidney. This acts as a guide during the surgery as the ureteroscope is passed through the ureter. A special x-ray called a retrograde pyelogram is then performed through a straw-like catheter which is used to inject contrast material up the ureter. This helps localise the stone precisely in the ureter.
The cystoscope is removed and a ureteroscope is passed up the ureter to visualise the stone. Small stones can usually be pulled out whole with a stone basket. Larger stones are shattered with a device called a lithoclast or laser. The fragments are removed or pass spontaneously.
After removing the stone it may be necessary to place a stent in the ureter and is easily removed in a couple of weeks.
Prior to your operation.
You will be required to fast for this procedure, normally 6 hrs prior to your procedure. If you have any x-rays relating to this operation, please ensure you bring them to hospital with you. Please discuss with your Doctor before the procedure if you are taking Aspirin, Warfarin, Plavix or Arthritis medication and any other blood thinning medication.
After the procedure.
This procedure is minimally invasive but may cause some discomfort immediately after surgery. You will be given pain relief as needed.
You may have a urinary catheter if your urine is heavily blood stained during the surgery (most do not require a catheter – this is more common if your stone is larger and more difficult to remove)
You may experience some discomfort when passing urine for several hours. Your urine may be blood stained. Drink plenty of fluid.
Please notify us or present to the Emergency Department at John Flynn Hospital if:
- You pass bright red blood or large clots in the urine
- High fevers, shivering, shaking
- Your urine becomes cloudy, smelly and you develop burning/stinging whilst passing urine
- Your are unable to pass urine