Ureteroscopic Stone Removal
The Procedure
Normally, a full general anaesthetic will be used and you will be asleep throughout the procedure.
A telescope is inserted into the bladder through the urethra. Under X-ray screening, a flexible guidewire is inserted into the affected ureter up to the kidney. A longer telescope (either rigid or flexible) is then inserted into the ureter and passed up to the kidney. The stone is disintegrated using a mechanical probe, ultrasound or laser and the fragments extracted with special retrieval devices. A ureteric stent is normally left in place after the procedure.
You will usually be able to go home on the same day of the procedure once you are passing urine normally.
Most procedures have a potential for side-effects and these are outlined below.
Common (greater than 1 in 10)
- Mild burning or bleeding on passing urine for short period after operation.
- Temporary insertion of a bladder catheter.
- Insertion of a stent with a further procedure to remove it.
Occasional (between 1 in 10 & 1 in 50)
- Inability to retrieve the stone or movement of the stone back into kidney where it is not retrievable.
- Kidney damage or infection needing further treatment.
- Failure to pass the telescope if the ureter is narrow.
- Recurrence of stones.
Rare (less than 1 in 50)
- Damage to the ureter with need for open operation or tube placed into kidney directly from back to allow any leak to heal.
- Very rarely, scarring or stricture of the ureter requiring further procedures.
When you get home, you should drink plenty of water to flush your system through and minimise any bleeding.
You may experience pain in the kidney over the first 24-72 hours, due to the swelling caused by insertion of the instrument or by the presence of a stent. Anti-inflammatory painkillers will help this pain which normally settles after 72 hours. Occasionally the stent can cause bladder irritation and pain in the kidney with urination until the stent is removed.
It will take at least 5-7 days to recover from the operation. You should not expect to return to work within 7 days.
If a stent has been inserted, it is vital that it not remain more than 3 months without removal or exchange.
If you develop a fever, severe pain on passing urine, inability to pass urine or worsening bleeding, you should contact Dr Rasiah’s rooms or your GP immediately.
Small blood clots or stone fragments may also pass down the ureter from the kidney, resulting in renal colic; in this event, you should contact Dr Rasiah’s rooms or your GP immediately.
