Going For Surgery

Back to List of Surgery

 About the Surgery

Ureteroscopy is a procedure whereby a very 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.

 Aim of Surgery

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(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 backpressure 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 is easier for your surgeon to remove the stone during the second procedure a few weeks later (Refer to diagrams in "Gallery")

 How Long is Surgery

30-60min

 Anaesthetic

General Anaesthetic
(You are put to sleep for the whole operation and will feel no pain or discomfort during the procedure)

 Incision/Cut

No skin incisions or cuts

The procedure is performed through the urethra (urinary passage)

 Description of Surgery

Your legs are placed in stirrups at the beginning of the procedure. The surgeon passes a telescope (cystoscope) through the urethra to the bladder. A full inspection of the bladder is performed.

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 localize the stone precisely in the ureter.

The cystoscope is removed and a ureteroscope is passed up the ureter to visualize the stone. Small stones can usually be pulled out whole with a stone basket. Larger stones are shattered with a miniature pneumatic device called Lithoclast. The fragments are removed or pass spontaneously.

After removing the stone it may be necessary to place a small internal drain up the ureter. This is called a stent and is easily removed in a couple of weeks.

 Complications of Surgery

There is a small risk of:

Bleeding - your urine may be blood stained after the procedure. This will usually settle without any specific treatment. You should drink plenty of fluid for several days (2-3 litres/day).

Infection - responds well to tablet antibiotics

Pain or burning sensation when passing water - responds to pain medication

Rare:

Damage to ureter - there is a very small chance of damaging the ureter during the procedure. This would require open surgery to repair the damage.

 Duration of Hospital Stay

Same day or following morning (for most)