What is ureteroscopy?
Ureteroscopy is a technique used for the treatment of ureteral stones. It consists of introducing a ureteroscope into the urethra of a ureterorenoscope which, thanks to a video camera, allows the specialist to analyze the organs of interest (in this case, the bladder, ureter and renal cavity). By using special probes, which can be rigid or flexible, it is also possible to fragment and remove the stones.
Why is it performed?
Ureteroscopy is the most commonly used technique to remove ureteral stones after extracorporeal lithotripsy, and its application is becoming more and more frequent thanks to the constant evolution of instrumentation. The stones that form in the ureter are very dangerous since they can cause an obstruction of the urinary tract. For this reason, the extracorporeal lithotripsy method has been established for the stones present in the upper ureter and the ureteroscopy for those located in the lower area.
Ureteroscopy is performed to treat ureteral stones.
What does it consist of?
Ureteroscopy is performed in the operating room under general or spinal anesthesia and usually lasts 10 to 45 minutes. For stones smaller than 5 mm, the ureterorenoscope is introduced into the urethra up to the ureter in order to locate and remove the stone using instruments that can be inserted into the ureter. For larger stones, it will be necessary to introduce a specific probe in order to fragment the stone (intracorporeal lithotripsy). The most frequent complications of this procedure are perforation of the ureter, stenosis of the ureter or refluxes, which may occur in 5-10% of cases. Another very serious complication, but fortunately very rare, is the detachment of the ureter (avulsion) which requires immediate surgical intervention. In general, the results offered by this technique are very satisfactory: in fact, they make it possible to successfully treat about 90% of cases of lower ureter stones.
Preparation for ureteroscopy
Ureteroscopy does not require any special preparation, but since it requires sedation, the patient must undergo tests such as chest X-rays, electrocardiogram, blood and urine tests before the operation.
Postoperative recovery
After this procedure the patient will have to undergo a short antibiotic therapy (7 days) before resuming normal daily activities: if a stent has not had to be placed during the ureteroscopy, the resumption of activities may require more time (maximum two weeks). After therapy, the patient should undergo clinical follow-up examinations and a urine culture. If a stent has been placed during the procedure, it should be removed after 2 to 3 weeks.