Ureteroscopy

What is Ureteroscopy?

A Ureteroscopy (yoo-ree’-tur-ah’-skopee) is a common procedure whereby a stone can be removed via a special telescope, or in certain cases, a laser can be used to break up the stone into very small bits. This procedure is generally done under anesthesia in the operating room and takes between 30 minutes and 2 hours, depending on the stone and your anatomy.

Your doctor will being by inserting a thin viewing instrument (ureteroscopy) into the urethra (the tube that leads from the outside of your body to the bladder). The ureteroscopy is then passed into the bladder and ureters (the tubes that carry urine from the kidneys to the bladder) in order to view the internal drainage system of the kidney.

After the stone is identified it can be grasped with a basket or grasping instrument and removed intact, or if the stone is too high in the ureter or embedded, a laser may be used to fragment the stone. The fragments are typically left to pass on their own.

After the procedure a small plastic/silicone tube called a stent may be placed to help the ureter heal. Your stent is NOT permanent and can cause significant problems if it is left in longer 4-6 months.

How to Prepare for your Procedure

Your doctor may advise you to stop taking certain medications prior to your surgery.

If you are taking medications that contain aspirin, ibuprofen, acetaminophen, blood thinners or arthritis medication, please notify your doctor prior to your procedure. Intake of these medications may result in the cancellation of your surgery. If you have any questions about your medications, please ask your doctor.

The Day of Your Procedure

DO NOT EAT OR DRINK ANYTHING AFTER MIDNIGHT! Please arrive 2 hours prior to your scheduled start time.

Make arrangements for someone to drive you home after you are discharged. Once you have been under anesthesia, you are unable to drive yourself home.

What to Expect after Your Procedure

After the procedure is complete you will be taken to the recovery room where you will be observed and then discharged after you are awake, your discomfort is controlled and you have urinated. You may be given a prescription for pain medication and antibiotics.

If you had a stent placed during your surgery, it will usually (but not always)have a string attached to make removal easy. Removal is typically done in the doctor’s office 5-7 days (or longer) later. If there is no string, the stent will be removed with the aid of a cystoscope and graspers in the office.

When You Go Home

Have someone drive you home. Do not plan to take a cab or a bus.

There may be continued pain in your side and possibly some new pains such as pain over the bladder area from the stent. You may experience a worsening side pain when urinating. This is normal as the stent now allows urine to reflux or regurgitate up to the kidney, applying pressure which is sensed as pain.

After your procedure you may experience an urgency to urinate, frequent voiding with small amount of urine or blood in the urine. If you had laser lithotripsy, you may pass small particles of stone that you should strain and try to collect.

If you had a stent placed, removal is typically done in the doctor’s office 5-7 days (or longer) later. This may sound scary, but it is quite quick and only mildly uncomfortable to most. Once the stent is removed, you may experience a recurrence of a fairly significant pain about 2-3 hours after the removal. This is unavoidable and has to do with the swelling of the ureter. You can pre-medicate yourself and plan to take it easy, perhaps a hot bath to aid with discomfort. This pain usually is fleeting, but is very commonly experienced by patients just after their stent is removed so BE PREPARED!

Call Your Doctor IF

  • you have severe or sustained pain
  • you have colicky or spasmodic pain that is not alleviated by taking your dose of pain medication and soaking in a tub of hot water for 30-45 minutes
  • your oral temperature is 101 degrees or more
  • you have constant leakage of urine
  • you have excessive bleeding.
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