Ureteroscopy

Ureteroscopy is a highly effective, minimally invasive procedure used to diagnose and treat stones in the ureters, as well as other conditions affecting the urinary tract. As a leading urologist in Belize, I often recommend ureteroscopy to patients who are experiencing ureteral stones, as it offers an efficient and relatively painless solution to remove stones and restore normal urinary function. In this post, I’ll answer common questions about ureteroscopy and discuss the benefits of both flexible and semirigid ureteroscopies.

What Is Ureteroscopy?

Ureteroscopy is a procedure where a thin, tube-like instrument called a ureteroscope is inserted into the urethra, through the bladder, and into the ureters (the tubes connecting the kidneys to the bladder). The ureteroscope allows me to directly view the urinary tract, identify the location of ureteral stones, and remove or break them up as needed.

What Are the Types of Ureteroscopy?

There are two main types of ureteroscopy, depending on the nature and location of the ureteral stones:

1. Flexible Ureteroscopy:
   A flexible ureteroscope can bend and move through the curved structures of the urinary system. It’s especially useful for stones located higher in the urinary tract, closer to the kidneys. The flexibility of this tool allows me to navigate the delicate and complex structure of the ureters with precision.

2. Semirigid Ureteroscopy:
   The semirigid ureteroscope is more straight and stiff, making it ideal for removing stones in the lower ureters closer to the bladder. This type of ureteroscopy is often preferred for stones that are easier to access without the need for flexible maneuvering.

Both procedures are done endoscopically, meaning they require no external incisions, making them minimally invasive options for stone removal.

What Are the Symptoms That Lead to Ureteroscopy?

Ureteroscopy is commonly used to treat patients who are experiencing the following symptoms due to ureteral stones:

• Severe flank pain or abdominal pain
• Blood in the urine (hematuria)
• Frequent or painful urination
• Nausea and vomiting due to ureteral obstruction
• Difficulty passing urine or complete urinary blockage

These symptoms are often caused by stones that have become lodged in the ureter, preventing normal urine flow and causing significant discomfort.

How Is Ureteroscopy Performed?

The procedure is performed under general or spinal anesthesia to ensure patient comfort. Here’s a step-by-step overview of what you can expect:

1. Insertion of the Ureteroscope:
   The ureteroscope is gently inserted into the urethra, through the bladder, and into the ureter where the stone is located.

2. Stone Identification:
   The ureteroscope allows me to visually locate the stone in real time. Once the stone is found, its size, shape, and position are assessed.

3. Stone Removal or Fragmentation:
   Depending on the size of the stone, it can either be removed whole with a small basket-like tool or fragmented using laser energy. The laser breaks the stone into smaller pieces, which are then either extracted or left to pass naturally through urination.

4. Post-Procedure:
   A temporary stent may be placed in the ureter to ensure proper drainage and healing. The stent is typically removed a few days to a week later in a follow-up visit.

What Are the Benefits of Ureteroscopy?

Ureteroscopy offers several key benefits for patients suffering from ureteral stones:

• Minimally Invasive: There are no external incisions, resulting in less pain and quicker recovery compared to open surgery.
• High Success Rate: Ureteroscopy is highly effective in removing ureteral stones, especially when other methods like medications or shock wave lithotripsy are not successful.
• Quick Recovery: Most patients can return to their normal activities within a few days.
• Precision: Both flexible and semirigid ureteroscopes provide excellent visualization of the urinary tract, allowing for precise stone removal.
• Outpatient Procedure: Ureteroscopy is typically performed as an outpatient procedure, meaning patients can go home the same day.

What Should I Expect After Ureteroscopy?

After the procedure, it’s normal to experience mild discomfort, such as:

• Slight burning sensation during urination
• Blood in the urine for a short period
• Mild lower abdominal or flank pain

These symptoms typically resolve within a few days. If a stent was placed, you may feel some urinary urgency or discomfort until the stent is removed. I will provide detailed aftercare instructions to help you manage any discomfort and promote a smooth recovery.

What Are the Risks of Ureteroscopy?

Like any medical procedure, ureteroscopy carries some risks, although they are rare. Potential risks include:

• Infection: This is managed with antibiotics and proper post-operative care.
• Injury to the ureter: In rare cases, the ureter may become injured, which could require further treatment.
• Discomfort from the stent: If a stent is placed, some patients may experience discomfort until it’s removed.

The overall risks are low, and ureteroscopy remains one of the safest and most effective methods for treating ureteral stones.

Why Choose Ureteroscopy for Ureteral Stones?

When medications or non-invasive treatments aren’t enough to pass ureteral stones, ureteroscopy provides a reliable solution. As your urologist, I will work closely with you to determine whether flexible or semirigid ureteroscopy is the best option based on the size and location of your stones. My priority is to ensure that the procedure is as comfortable as possible and that you achieve a full recovery.

Final Thoughts

Ureteroscopy is a highly effective and minimally invasive procedure for the treatment of ureteral stones. Whether flexible or semirigid, the procedure offers quick relief from painful symptoms and helps prevent further complications. If you’re experiencing the discomfort of ureteral stones, I encourage you to schedule a consultation so we can discuss the best treatment plan for you.