Endourology refers to a specialty area of Urology in which small internal endoscopes and instruments are used to see into the urinary tract and do surgery. It is a minimally invasive surgical technique through which kidney stones can be treated. Kidney stones can be extracted or fragmented by using the tiny instruments and endoscopes through the natural body channels such as the urethra, bladder, and ureter.
Endourology can also be used to determine what causes kidney stones and helps to prevent more from forming. Most endoscopic procedures are done on an outpatient basis. The instruments used are flexible and include lasers, graspers, miniature stone retrieval baskets, cautery, and special scalpels. The use of these instruments can be advanced through working channels.
What are the different endoscopic procedures?
Extracorporeal Shock Wave Lithotripsy:
Extracorporeal Shock Wave Lithotripsy is a minimally invasive technique used for the disintegration of stone. It involves the administration of shock waves generated by a machine called a lithotripter. After the lithotripter is calibrated and the stone has been targeted, shock waves are focused and passed through the body. This is done in a manner in which the maximum energy of the shock waves is dispersed at the site of the stone to disintegrate it. The pulverized fragments of the stone are then passed through the patient’s urine.
This procedure is the best for smaller stones. The success of this treatment depends on stone composition and the specific anatomic location of the stone within the urinary tract.
The ureters are the narrow tubes that carry urine from the kidney down to the bladder. Ureters are usually small in caliber but when obstructed, they dilate. For performing ureteroscopy, a precision instrument called ureteroscopes is used. Ureteroscope is used to surgically treat the obstruction in the ureters. At times, it may be used to traverse the length of the ureter to perform a kidney procedure.
Percutaneous Renal Surgery:
This surgical procedure involves placing the catheter through the skin in the patient’s back into the drainage system of the kidney. After the catheter is placed, the passageway can be dilated to facilitate the placement of working tubes and instruments to remove or pulverize stones and perform any other necessary procedures. This procedure is more invasive and offers considerable benefits in comparison to open surgery which was used in the past to treat large kidney stones and other kidney diseases.
Cystoscopy is an endoscopic procedure that allows the doctor to look inside and examine the bladder and the urethra using a camera called a cystoscope. A cystoscope is a hollow tube that is equipped with a lens. It is inserted in the urethra and passed into the bladder for the doctor to look inside. Through the cystoscope, small instruments can be passed down the bladder to treat bladder problems.
Nephroscopy is an endoscopic examination of the kidney. It is a nonsurgical way of examining the inside of the kidneys and treating conditions in the upper urinary tract. It is also used to treat problems such as kidney stones and tumors of the kidney lining. Nephroscopy is performed using a small instrument called a nephroscope. Nephroscope is a thin flexible tube in which the flexible part of the tube is inserted into the skin through a very small incision.
Ureteroscopy is performed if and when the surgeon needs to have a thorough look at the bladder or the urethra or need to take a sample of tissues from the lining of either area to clarify a particular problem. Ureteroscopy is used to treat stricture blockages of the urethra.
How to know if you are a suitable candidate for Endourology?
If you want to know your suitability for endourology, you need to meet and get evaluated by an endourologist. The doctor will take into account your medical history and the nature of the particular disease. After a proper and detailed evaluation is done, your doctor will let you know if you can go for endourology or not.