Ureteroscopy & Allied Procedures

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What is Ureteroscopy?

Ureteroscopy refers to the endoscopic procedure used to remove the small or medium-sized stones from the urethra using a small telescope. In this procedure, a small ureteroscope is used for removing the stones from the urinary tract. Small stones are often removed using a stone basket, whereas large stones are first broken into tiny pieces and then removed from the urethra.

Symptoms of a stone

Extreme pain- Intense pain is felt in the lower abdomen. The pain begins when the stone starts moving. Stone pain has been always described as the most severe pain ever. It also causes irritation and blockage in the urinary tract.
The urgency to urinate – When the stone is at the ureter, the urgency to urinate increases which also leads to a mild burning sensation while passing out urine.
Blood in urine- In severe cases, the blood often comes out with urine. This situation is treated as an alarming situation wherein the patient needs to consult a doctor immediately. The blood comes out due to severe damage in the ureter and due to spikes on stones.
Nausea and vomiting- Symptoms such as weakness, nausea, and vomiting are experienced because of intense pain in the abdomen due to the movement of the stone.
Fever – Frequent fever and chills are also felt due to stone. In such cases, one should immediately consult a doctor before it gets worse.
No symptoms – Sometimes, when the stone is in the growing stage, it doesn’t show any symptoms, and eventually, when the stone becomes large it starts causing pain when the bladder tries to push the stone to come out.

Preparations before the surgery

Before the surgery, the person is asked to discontinue some medications at least 7-10 days before surgery. Medications such as blood thinners, aspirin, vitamin- E, and other supplements are asked to discontinue before the surgery.
The medications are asked to stop because these medicines can disturb the platelet function or alter the clot making capability of the body which may lead to bleeding during and after surgery.
One should ask the surgeon about the medications to take or not to.
The patients are also asked to not drink, eat, or smoke at least 6-8 hrs before the anesthesia.
Before the surgery, the bladder is fully emptied and then the anesthesia is prepared.

Process of surgery

Before performing the surgery, a small amount of anesthesia is given to the patient for making the person fall asleep. The surgery starts when the surgeon passes the ureteroscope through the urethra, and bladder up to the location of the stone. X-ray images are used by the surgeons to see the exact location of the stone and to see other abnormalities. Once the stone is visible, the smaller stones are removed directly using a “stone basket”.
The large stones are then broken into small pieces using a laser, and then these pieces are removed from the ureter.

After effects of the surgery

In some cases, a stent is placed in the ureter to facilitate urine flow as the ureter can swell due to the surgery.
Blood-pressure, heart rate, and pain are checked regularly after the surgery is completed.
Slight to moderate pain is felt in the abdomen after the surgery.
A small amount of blood, the mild burning sensation is also experienced while urinating.
Discomfort in the bladder and kidney can be felt while urinating.

Suggestions for the first week after surgery

After the surgery, the first week is very crucial, it is suggested to take complete rest and proper medications.
To facilitate urine flow, one should drink more fluids. About 1.5l of water in a day is suggested.
Healthy, and green leafy vegetables should be eaten. Meat should be avoided in the first week after surgery.
To avoid urinary tract infections, it is advisable to not have sex in the first week after surgery.