ureteroscopy

A ureteroscopy is a minimally invasive outpatient procedure that urologists perform to diagnose conditions affecting the urinary tract. It is most often used to treat urinary stones. It may also help address other types of blockages within the urinary system. The procedure may be done using two different approaches. This article explains what is ureteroscopy and how the procedure is performed.  What is Ureteroscopy? Ureteroscopy is a medical procedure to examine the kidneys and ureters using a specialised instrument called a ureteroscope. It is commonly performed to identify and manage blockages, stones, or other abnormalities within the urinary tract. A ureteroscope is a slim, tube-like device fitted with a light and a small camera or lens that helps the provider view the urinary system clearly. Tiny instruments can also be passed through the scope to treat certain conditions during the procedure. A rigid ureteroscope is generally used for issues located in the lower ureter near the bladder, while a flexible ureteroscope is preferred for conditions affecting the upper ureter and kidney. What is Ureteroscopy used to treat? Ureteroscopy is used to identify and manage conditions affecting the urinary tract, including: The procedure may also be recommended to investigate and treat possible causes of blood in the urine. Ureteroscopy can be an effective treatment option for people who: In many cases, ureteroscopy is used to treat stones measuring between 5 and 20 mm. How common is ureteroscopy? Ureteroscopy is a widely performed procedure for treating stones within the urinary tract. Kidney stones are relatively common, affecting around 1 in 10 people in the United States at some point in their lifetime. Although kidney stones have traditionally been more frequent in males, the difference in occurrence between males and females has been decreasing over time. What is the procedure for ureteroscopy? During a ureteroscopy, a thin instrument called a ureteroscope is carefully guided through the urethra, into the bladder, and up the ureter toward the kidney. This allows the healthcare provider to locate, break apart, or remove kidney stones that are unable to pass naturally through the urinary tract. Is ureteroscopy a major or minor procedure? Ureteroscopy is a minimally invasive procedure, not a major surgery. It is commonly performed as an outpatient treatment, meaning most people can return home the same day. How to prepare for a ureteroscopy Your healthcare provider will give you specific instructions before the procedure. Preparation steps may include: Who is part of the care team? A ureteroscopy procedure is typically carried out by a specialised healthcare team, which may include: What happens during the procedure? Before the procedure begins, the anesthesiologist or certified registered nurse anesthetist (CRNA) will administer general anesthesia through an IV line, usually placed in your arm. This ensures that you remain asleep, comfortable, and free from pain throughout the procedure. Once the anesthesia takes effect, the urologist gently inserts the ureteroscope through the urethra and advances it into the bladder and urinary tract. There are generally two main approaches used during ureteroscopy to treat stones: The treatment method chosen depends on several factors, including the stone’s size, location, and mineral composition Is a stent necessary after ureteroscopy? After the procedure, they usually place a ureteric stent to help the urinary system heal properly. One end of the stent is placed in the kidney, and the other in the bladder. The stent keeps the ureter open, allowing urine and any remaining stone fragments to pass more easily during recovery. Since the stent stays entirely inside the body, there is no need for an external urine collection bag. It is typically removed within a few days to a couple of weeks after the ureteroscopy. In some cases, the stent may have a small “pull-out” string that passes through the urethra and is taped to the leg. This makes it possible for the patient to remove the stent at home if advised by the doctor. Alternatively, a nurse or healthcare professional can remove the stent during a follow-up office visit. What happens after the procedure? Following the procedure, healthcare providers will observe you in a recovery area for about 1 to 2 hours to ensure you are recovering well from anesthesia. They will also provide instructions on managing any mild pain or discomfort after the procedure. Since ureteroscopy is typically performed as an outpatient procedure, most patients can return home on the same day. In some cases, the removed stone may be sent to a laboratory for further analysis. Examining the stone helps identify its type and possible cause, which can also assist in planning strategies to reduce the risk of future stone formation. How long does the procedure take? A ureteroscopy generally takes around one to two hours to complete. However, including preparation time and post-procedure recovery, patients should expect to spend approximately four hours or more at the hospital or surgical center. What are the benefits and risks of ureteroscopy? Benefits of ureteroscopy Ureteroscopy offers several advantages for the treatment of urinary stones and related conditions, including: Possible risks and side effects Although ureteroscopy is generally considered safe, like any medical procedure, it may involve certain risks or complications, such as: It is also common to notice some blood in the urine after the procedure, especially when a stent is in place. The urine may appear darker or bloodier during physical activity, but light activities such as walking are generally encouraged. Drinking plenty of water can help flush the urinary system and keep the urine clearer during recovery. For patients with multiple or very large stones, an additional procedure may sometimes be needed to completely remove all stone fragments. Healthcare providers usually discuss this possibility before treatment. How painful is ureteroscopy? Most patients describe discomfort after ureteroscopy as mild to moderate. Pain and irritation can often be managed with: What Is the Recovery Process and Outlook After Ureteroscopy? Recovery after the procedure Most people can resume their usual daily activities within a few days after the ureteral stent is removed. However, while