Ureteroscopy (URS)
What we do at Urosonic?
At Urosonic, where exceptional kidney stone care meets a soothing environment we carry out minimally invasive surgery known as ureteroscopy to effectively remove kidney stones, utilizing the latest equipment and techniques. Ureteroscopy is a surgery performed to extract kidney stones that are present in the upper, middle and lower ureteral region. With more than 20 years of experience, our skilled urologists are dedicated to providing personalized treatment programs that are suited to each patient’s specific needs.
We prioritize your comfort and well-being, combining advanced technology with compassionate support to ensure a smooth and efficient recovery process. Our inviting ambience creates a healing atmosphere that feels more like a retreat than a healthcare facility. Let us help you find relief and restore your quality of life in a space designed for your comfort.
Why choose Ureteroscopy at Urosonic?
- It is a minimal invasive procedure with no incisions or cuts.
- Lower Risk of complications such as infections, bleeding, and scarring due to minimum invasion
- Very short hospital stay of not more than 24 hours
- Reduced healthcare costs due to shorter hospital stay
- Recovery time is low. Patients can get back to their routine within a week
- Less post operative pain hence reducing the need for strong pain medications
- Due to its broad applicability it can be used to extract stones at any point in the ureter i.e from the upper portion near the kidney to the lower portion which is the bladder
- Due to direct access and visualization of the kidney stones in the ureter, the success rate of Ureteroscopy is very high.
What is Ureteroscopy (URS)?
Ureteroscopy (URS) is a less-invasive medical treatment for kidney stones. It is necessary when the stones resist medications and other non-surgical treatments. Ureteroscopy will be utilized mostly for stones that cannot pass and hence become trapped in the upper , middle or lower ureter, the tube that links the kidney and bladder. The ureters are small, muscular tubes that pass urine to the bladder from the kidneys, each measuring around 25-30 cm long. These tubes are vital to the urinary system because they drive urine through peristaltic waves and periodic contractions of the ureter wall muscles.
A urologist does the procedure in an operation room or an outpatient surgery center. Ureteroscopy usually takes 30 minutes to 2 hours. The procedure typically requires general or local anesthesia depending upon the patient. Nevertheless, no surgical incisions are made on your body by the urologist. The urologist examines your urinary tract, including your kidneys, ureters, and bladder, under anesthesia with a video scope called a ureteroscope.
A ureteroscope, a slim, flexible tube, is inserted into the urethra, bladder, and ureter during URS procedure. The urologist locates the kidney stone and uses laser radiation to break it into tiny bits, or he removes the fragmented kidney stones with a small basket. Ureteroscopy is more direct and successful. After the treatment, the urologist may put a thin plastic tube called a ureteral stent inside your urinary tract to decrease swelling and allow the kidney to discharge urine. The stent stays in your body for 4 to 7 days before being removed at a follow-up consultation. This procedure is preferred because of its high successful stone passage rate, involving less recovery time and fewer complications than other invasive surgeries.
Types of Ureteroscopy (URS)
Ureteroscopy for kidney stone extraction
Ureteroscopy is performed to extract renal stones from the ureter by changing their position with forceps that end in a basket and the remaining devices. The urologist passes a small basket-like structure through the ureteroscope to catch the kidney stone and extract it from the body.
Ureteroscopy with holmium laser lithotripsy (URSL)
This is the most commonly applied procedure when the kidney stone is too big. The laser cuts the stone into smaller fragments, enabling the basket forceps to grab and remove it easily. The stone fragments can subsequently be retrieved with a basket or allowed to pass through the urine.
Ureteroscopy for placement of stent catheter
This is a procedure in which a ureteral catheter is inserted to relieve obstruction, i.e., the channel blocked by stone, internal tumors, or disease-related external material that is opened. The stents maintain urethral dilatation for easier handling of the tools during the surgery, allowing urine to pass without blockage and thereby decreasing discomfort. Stents also provide help during the healing process.
Ureteroscopy for biopsy and tumor removal
Aside from cancer treatment, Ureteroscopy can be used to reach the problematic area with laser forceps and perform a biopsy to assess whether the tumor is malignant or benign. The tool used is a brush, which is used to gather internal tissue from the afflicted location, which is usually the ureter, and then extracted for microscopic analysis.
Why and when is Ureteroscopy (URS) done?
The Ureteroscopy (URS) procedure is performed based on the kidney stone size, location, and composition as well as the patient’s health.
Small to moderate-sized stones:
• URS is best successful for stones less than 20 mm (2 cm) in size. Larger stones may necessitate various treatment strategies, such as percutaneous nephrolithotomy (PCNL) or a combination of treatments.
• Stones lodge anywhere along the ureter.
URS is effective for treating stones in the upper, middle, and lower ureters, when other non-invasive procedures may be ineffective.
Urethral stones:
• URS can effectively cure stones in the ureter, which links the kidney and bladder.
• The procedure enables direct viewing and treatment of stones in the ureter.
Renal pelvis stones:
• Kidney stones present in the collecting room of the kidney, which is the renal pelvis, can be removed with URSL.
Kidney stones those are resistant to other treatments
• URSL may be a viable option if more conservative methods, such as fluid intake or medication, have failed to help with stone passage.
Blockage and immense pain:
• Stones causing severe pain, fluid retention, or reduced kidney function can be removed using URSL.
Ureteroscopy Procedure
Pre–operative Procedure
X-rays and laboratory analysis will confirm your safety during the treatment.
You will be asked to change your clothes and pee before you are led into the operation theater.
You will be given an intravenous (IV) or oral antibiotic prior to the surgery.
Operation Procedure
The anesthesia staff will connect monitoring equipment to you. This operation will require you to be under general or spinal anesthesia.
After administering anesthesia, you will be asked to lie in a "lithotomy" position.
An optical cystoscope will be introduced through the urethra to inspect the bladder's interior.
X-ray pictures can be obtained by introducing contrast dye into the ureters to outline the urine channel and stone placement.
To locate the stone(s), the ureteroscope is inserted via the urethra, bladder, ureter, and kidney collecting system. No cuts or incisions are made, and the ureteroscope is introduced upstream along the natural urine flow.
The stone can be grasped and removed with the ureteroscope by passing a tiny wire basket down the operation path.
Large stones can be fragmented using laser or electro-hydraulic energy delivered through a ureteroscope fiber.
Depending on how much stone is present, the treatment can take one to two hours.
Prior to being sent home following the surgery, you will typically be observed in the post-operative recovery area for two hours.
Post-Procedure Care
After the procedure, a stent may be inserted in the ureter to prevent swelling from obstructing urine drainage.
The stent is often removed within 1-2 weeks of performing ureteroscopy by a small procedure at your healthcare center.
A thread can be affixed to the end of the bladder and taped to the skin near the urethral entrance. This permits you to remove your stent at home two or three days after treatment.
You will be given oral narcotic medications for pain treatment at home. Other drugs may be used to ease the ureter (for example, Flomax) or to relieve inflammation and pain.
Between 4 to 6 weeks of surgery, after removing the stent if inserted, an X-ray is taken to determine the success of the treatment and to rule out any problems.
If you are at risk of recurring stones, further testing may be recommended to prevent future occurrences.
Risks associated with Ureteroscopy (URS)
- Up to 15% of patients experience significant abdominal pain, constipation, or bladder irritation.
- Less than 5% experience severe symptoms.
- Bleeding happens during URS due to the manipulation of the instruments in the ureter and kidney which is typically minor and resolves independently.
- There can be a marginal risk of infection like bacteria due to the instruments inserted into the ureter.
- There can be minor obstructions due to small kidney stone fragments or swelling in the ureter causing pain or difficulty in passing urine. In such cases, a stent is inserted to remove the obstruction and allow easy passage of the urine.
- Small residual stone fragments may remain in the urinary tract, potentially growing over time.
- There could be an allergic reaction caused because of anesthesia or contrast dye during the procedure which is rare.