Lakeshore Urology

Lakeshore Urology , PLC
Serving Grand Haven, Muskegon, Shelby and the Lakeshore of West Michigan  (616) 604-8363
 

Kidney Stones

Ureteroscopy and Stone Manipulation

Ureteroscopy


Ureteroscopy is the examination of the inner lining of a ureter using a ureteroscope that is first passed through the urethra and bladder.  It is commonly used to visualize kidney stones caught in the ureter so that they can be treated.


This procedure is generally performed under general anesthesia in an outpatient setting.  An IV will be started, an antibiotic given to protect against infection, and you will be sedated-- thus not aware of the procedure.  The procedure generally takes about an hour, but there are several more hours spent in preparation and recovery.

Stone Manipulation


During ureteroscopy, if a stone is visualized the surgeon may attempt to remove it by scooping it out with a "basket"-- a loop of fibers that are roped around the stone in order to pull it out.


To the left, you can see several photographs of a large kidney stone being removed with basket. Notice the small amount of trauma to the ureter after the stone is removed.


If the stone is too large or lodged too tightly,
the surgeon may use a laser to blast the stone.

When a stone is not easily removed by "basketing", the surgeon will often use a holmium laser which will blast the kidney stone into fragments which are more easily removed.

To the left is a stone being treated by a holmium laser.

Very often, a ureteral stent is placed after ureteroscopy in order to keep the ureter from swelling shut from trauma during the procedure.  If one is placed, it is generally removed after a week.
As with any procedure, there are risks, including bleeding, infection, anesthesia reaction, failure, damage to adjacent tissues, post procedure discomfort.  You will need a driver. You will follow up with our office in a week and get an abdominal X-ray prior to that appointment.

Ureteroscopy and Stone Manipulation


Post Procedure Instructions:

 




You should:

  • Increase your fluid intake
  • Strain your urine until seen in the office and collect the stone fragments. The fragments will look like grains of sand.


Restrictions:

  • You can work or lift as tolerated
  • Plan to take at least two days off.


You can expect:

  • Some flank pain and colic like pain as the fragments of stone pass.
  • Blood in the urine


You may have a ureteral stent after your surgery.  If so you can expect:

  • Feelings of urinary urgency and frequency
  • There will be blood in the urine as long as the stent is in place. This is normal
  • If the bleeding becomes excessive (large clots) you should decrease your activity and increase your fluid intake


You should call the office:

  • If you develop a temperature of 100.6 or greater
  • If you are not contacted for a follow up appointment one business day after your surgery


You should seek immediate medical attention:

  • If you have persistent nausea and vomiting
  • If pain medication is not adequate
  • If you develop calf tenderness or swelling, seek immediate medical attention