Ureteroscopy with Laser Lithotripsy
What is Ureteroscopy?
Ureteroscopy is a procedure that involves the use of a thin, long tube called a ureteroscope, to examine, diagnose and treat urinary tract problems. The ureteroscope is most commonly used for the diagnosis and treatment of kidney stones but is also indicated for the treatment of various conditions such as frequent urinary tract infections, urinary blockage, hematuria (blood in the urine), unusual cell growth or tumor in the ureters (urine tubes). Ureteroscopes may be flexible, or rigid and firm.
How is the procedure performed?
Ureteroscopy is an outpatient procedure, performed under spinal or general anesthesia. Your doctor inserts the tip of the ureteroscope through the urethral opening (opening of the urinary bladder to the outside) and advances it up the urinary bladder and into the ureter (kidney tubes that empty urine into the bladder). No incisions are made. A sterile liquid is passed through the ureteroscope to fill and stretch the bladder. This helps your doctor to clearly view the bladder wall, locate the stone and diagnose any abnormalities.
To remove the stone, your doctor may insert a thin wire with a tiny basket attached to its end through the ureteroscope. The basket grabs and removes the kidney stone. Your doctor may sometimes break a large stone with the help of laser emitted through a flexible fiber passed through the ureteroscope.
The complete procedure takes about 15 to 30 minutes. After the procedure, you may feel a mild burning sensation during urination. You will be advised to drink plenty of water to relieve post-operative discomfort. Your doctor may prescribe antibiotics for a few days to prevent infection.
What risks or complications are associated with the procedure?
Like most therapeutic procedures, ureteroscopy may be associated with certain risks such as:
- Abdominal pain
- Injury in the ureter
- Urinary tract infection
How many treatments are needed?
Typically, one ureteroscopy session is all that is needed to clear the stone burden and render a patient “stone free”. In rare instances, a staged procedure with two treatments may be needed in patients with numerous stones or a very large stone.
Consultation and Preparation
Before undergoing the procedure, you must first schedule an initial consultation with Dr. Dhir. During this time, he will conduct a thorough assessment of your current health and ask you about your medical and surgical history. You will also have to undergo a physical examination to determine your eligibility for the treatment. Additional urine and blood tests may also be performed.
If you are recommended surgery, you will have to take certain steps to get your body ready for the procedure. A cardiac clearance may be needed from a cardiologist if you have a significant history of heart attack, heart failure or stroke.
Dr. Dhir may advise you to discontinue the consumption of blood-thinning medications like Aspirin or Plavix. It’s vital that you refrain from consuming these medications as they may hinder your body’s blood-clotting ability, which can result in unwanted bleeding during the procedure and/or recovery.
Finally, active urinary tract infections must be completely treated prior to ureteroscopy. If you have symptoms of a UTI, such as burning with urination, lower abdominal or back pain, or an urgent need to void, make sure to let Dr. Dhir know prior to scheduling.
Following the completion of the surgery, your urine may contain small traces of blood. However, this isn’t something you have to worry about and will subside in time. If you maintain proper hydration levels and give it time, your urine should gradually become clear. Dr. Dhir will also provide medication to help keep you comfortable if you experience bladder spasms or flank pain.
You should also be careful not to resume regular activities immediately after the surgery. Ideally, you should wait at least several days before commencing normal activities. Also, refrain from driving as long as you are on pain medications. You may also experience symptoms such as fatigue and nausea during recovery. However, with proper rest, these symptoms should go away.
A follow-up appointment will be scheduled by Dr. Dhir’s office staff for several weeks after the procedure. This is to ensure you are healing appropriately, have no traces of infection in the urine, and to ensure the ureter is draining urine without evidence of obstruction. Preventative studies may be ordered at that time if ureteroscopy was done for kidney stone disease.
Contact Our Office
Dr. R. Robert Dhir is a board-certified urologic surgeon who is dedicated to helping improve lives through advanced Urologic services. If you’re interested in learning more about ureteroscopy with laser lithotripsy, contact our office to schedule your consultation today.