Ureteroscopy is the process by which an instrument is passed into the ureters through the urethra and urinary bladder. The instrument used is a special endoscope known as a ureteroscope. There is a tendency for calcified solids to form in the urinary tract, especially in the ureters (the tube through which urine passes from the kidneys to the urinary bladder) and the kidneys. These calcified solids are called stones. Through the process of ureteroscopy, this region is examined and stones are detected.
Later, by using the ureteroscope again, with some special attachments, the stones are either physically extracted or fragmented into flushable bits by lasers or ultrasonic waves. Ureteroscopy although invasive to some extent, eliminates the necessity of making surgical incisions. It is mostly an outpatient surgical procedure and the patient can go home soon after the operation.
The minimum requirements are stones in the urethra, kidney or the ureters. Ureteroscopy is also performed if there is some obstruction in the ureter, for detecting the cause of the obstruction.
The symptom which indicates that a ureteroscopy might be required is blood in the urine, which should never be taken lightly under any circumstances, as the cause of bleeding may be kidney stones, lesions or tumors.
The most common occurrence is when the stone has formed in the kidney but which has dropped to the ureter. When an x-ray does not show a stone, and when ESWL (shock wave lithotripsy) cannot or is not done, then requirements demand that a ureteroscopy be performed.
The size and location of the stone dictate whether the stone should be treated with a flexible or rigid ureteroscope.
There are a few preparations to be done before the operation:
It is advisable for the patient to ask the doctor about special precautions to be taken.
A complete medical history of the patient will be required.
As in any surgery, a consent form will have to be signed.
A urine test may be required before the surgery, in which case, urination should be avoided just before the urine test.
In some cases, spinal or general anesthetic may be required. If so, the patient should arrange for some provision to be driven back home.
A list of medication being taken by the patient will have to be made.
Any allergies or resistance to particular drugs should be flagged up before the operation is performed.