Stones found in the lower portion of the ureters are usually removed by inserting a ureteroscope through urethra. Laparoscopic surgeries are also performed for larger stones which were previously removed only by open surgeries.
Ureter is normally 6 mm in diameter. A ureteroscope is a special telescope with a diameter of 2-3 mm only which can be passed into the ureter via bladder to visualize the stone on a TV screen placed before the surgeon with magnification up to 10 to 15 times. Through this ureteroscope laser probes are inserted to the area where the stone is located and the stones are powdered. Larger pieces of fragmented stone are collected for stone analysis and the smaller pieces are allowed to pass through the urine. After the surgery a 2 mm stent may be left inside your body which may be extending from kidney to the bladder. This stent helps better healing of the ureter and quick recovery of the kidney. The stent will not be visible outside and can be removed anytime between one month and three months. Removal of stent is usually done as an outpatient service.
Pre operative preparations
Pre operative checkups to ascertain the general health condition of the patient and his response to anesthesia will be conducted a few days before the admission for Ureteroscopy. Your preference for general of spinal anesthesia has to be informed to the anesthetist so that he can consider the possibility of having the anesthesia of your choice. Preparations like shaving your private parts will be done on the previous day of the surgery. On the day of the surgery the patient is expected to fast for 6 hours.
Post operative care
After completing the ureteroscopy the patient will be brought to the recovery room where he will be under intensive care. He will be carrying a urine catheter for one day which is intended to reduce the pain and difficulty in urinating. After spinal anesthesia 24 hours bed rest will be necessary. The patient will be advised to drink a lot of water so that a urine output of 2.5 liters/day can be maintained and infections can be avoided. The patient will be discharged the next day following surgery. He will be advised to review after 5 days. DJ Stent removal will be done on 5th day following surgery.