Ureteropyeloscopy, commonly known as ureteroscopic kidney stone removal, is one of the primary procedures used for noninvasive treatment of kidney stones. As with all medical procedures, there are potential complications, but ureteroscopy has shown to be exceptionally reliable.
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The National Kidney Foundation says that more than 90 per cent of kidney stones are allowed to pass through the urine stream on their own. In extreme instances, surgery or another type of medical procedure may be necessary. This often is the case when an infection has developed, blockage is occurring or when the stone is just too large to pass through such a small channel
In the process technically known as ureteropyeloscopy, urologists insert a long, thin device called an ureteroscope into the patient's urethra. This is moved through the bladder to the stone inside the ureter (the tube between the bladder and kidney) where the doctor can see the kidney stone through a miniature camera inside the ureteroscope. The decision is then made whether to remove it with an instrument called a stone basket or to disintegrate it with a laser beam. This procedure is normally reserved for stones that become stuck in the ureter during their trip to the bladder. A short hospital stay may be required although the treatment is usually performed on an outpatient basis. The operation takes one to three hours, with either a local or general anesthetic.
Ureteroscopy does hold some minimal risk. Scar tissue may develop inside the ureter and occasionally the ureter is accidentally perforated. Stones that have been stuck in the wall of the ureter for more than two months increase the risk of these complications. Physicians may insert a urethral stent, a soft tube that prevents blockage as a result of swelling. It normally is removed after a few days when swelling subsides.
"Pain, discomfort, urinary leakage, or infection can all be symptoms of a urethral perforation," says Dr. Kevin Pho of the medical blog KevinMD.com. "If this is the case, treatment would involve stenting or surgery, depending on the size and location of the perforation. This question should be discussed with your personal urologist."
There are some very basic complications associated with the ureteroscopic procedure, but none that are especially out of line with what one would expect from an operation of this sort, according to physicians at Mount Nittany Medical Center in State College, Pennsylvania. "For a few days after surgery, you may feel some pain when you urinate," they say. "Or you may need to urinate more often, or have bloody urine."
Patients should contact their urologist immediately if blood in the urine is exceptionally heavy, if one experiences sudden and extreme flank pain or if severe nausea exists for more than a few days.
Physicians at Cornell University's Department of Urology report there to be very few ureteroscopic kidney stone removal complications. "Regarding stone disease, ureteroscopy is excellent," says the university. "Up to 95 per cent of patients who undergo ureteroscopy for stones are made stone free. Very few complications have been noted in this group of patients with the majority of patients returning home the day of or 24 hours after the procedure."
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