Ureteroscopy

Telescope Examination of Ureter and Kidney

Ureteroscopy is typically carried out for kidney stones which lie either in the ureter or within the kidney. Ureteroscopy is also carried out for investigation of blood or abnormal cells coming from one kidney, blockage of the kidney, or occasionally for tumours within the ureter or kidney.

The procedure is carried out under a general anaesthetic.

During the procedure a fine telescope is passed into the bladder and up towards the kidney. In order to reach all parts of the kidney, a flexible ureterorenoscope is used. In cases involving kidney stones, a laser is used to break the stone into small fragments which would then usually be removed. At the end of the procedure a ureteric stent may be left inside for approximately one week.

After Ureteroscopy

You will probably have some burning or bleeding on passing urine for a short period after the procedure. Occasionally this carries on until the stent is removed. Stent removal is typically carried out with a telescope either under a local or general anaesthetic. A booklet entitled “Having a ureteric stent: What to expect and how to manage” is available on request.

Limitations of Ureteroscopy

Occasionally it is not possible to pass a telescope up to the stone because of narrowing in the ureter. Sometimes the stone proves to be in an inaccessible part of the kidney or the stone is simply too large for treatment with the fine ureteroscope. This may necessitate further treatment in the form of keyhole surgery or shockwave lithotripsy. Occasionally the ureteroscopy needs to be repeated one or more times to remove all the stone fragments. Mr Keeley will discuss the likelihood of these eventualities in detail with you prior to the procedure as well as afterwards.

A urinary tract infection is possible afterwards and so strong antibiotics are given at the time of the procedure to minimise this risk. If you notice your urine becoming cloudy or signs of cystitis then you should inform either your GP or Mr Keeley for antibiotic treatment. Cystitis-like symptoms can occur from a stent and may not settle down until the stent is removed.

Even after successful ureteroscopy, kidney stones may reoccur. Rarely some damage occurs either from the stone or from the procedure which leads to a narrowing of the ureter. This usually is treated with further ureteroscopy but occasionally requires an operation.

While all of these problems are possible, most patients in fact go through the procedure without any of these occurring.

If you have any questions about your treatment or any of the above information, please ask Mr Keeley for further clarification.