Have you ever had a sudden, unbearable pain that starts in the side of your back and goes down to your lower abdomen? Sometimes this pain is accompanied by nausea and blood in your urine. Anyone who has experienced this knows how difficult it is. Most of the time, this severe pain is caused by kidney stones or stones in the urinary tract. In the past, major surgeries were required to remove these stones. But now, medical science has advanced. Today, we are going to talk about Ureteroscopy, a very effective and simple method used to remove such stones.
What exactly is Ureteroscopy?
Simply put, Ureteroscopy is a procedure that uses a very thin, long, flexible tube with a camera (ureteroscope) to go down your urethra and remove or examine stones in your ureters and kidneys. It doesn't make any cuts in your body, so you heal quickly.
Imagine, you have two very thin tubes that carry urine from your kidneys to your bladder. We call these the ureters. Sometimes, when kidney stones move down these tubes, that terrible pain comes. Ureteroscopy is a very effective way to remove these stuck stones. This is often an outpatient procedure that can be done the same day, without having to stay in the hospital.
This involves inserting a thin camera through a natural opening in your body (the urethra). Therefore, no incisions are made on the outside.
How is this treatment done?
You will be completely unconscious (anesthetized) during this procedure. So you will not feel any pain. The doctor will insert a thin tube called a ureteroscope through your urethra, through your bladder, and up the urethra where the stone is. This is done by viewing the images from the camera on the tube on a monitor.
Once the exact location of the stone is determined, the method of removing the stone depends on its size. There are two main methods.
| Stone size | Treatment method |
|---|---|
| Small Stones | If the stone is small, the doctor will pass another thin wire through the ureteroscope. The wire has a small basket at the end. The stone is then gently removed from the basket. |
| Large Stones | If the stone is large, it is difficult to remove it from the ureter. In such cases, a thin fiber is passed through the ureteroscope and a laser beam is directed at the stone. The power of this laser beam breaks the large stone into small pieces (similar to grains of sand). The crushed pieces are then easily washed out with urine. |
Your doctor will determine the best method for you based on the location, size, and nature of your stone.
Who needs ureteroscopy treatment?
A doctor may typically recommend this treatment in the following cases:
- Blood in the urine: Blood in the urine can indicate an injury, infection, or other problem somewhere in the urinary system. This method can help pinpoint the cause.
- Blockage of the ureter or kidney: Stones or other tumors can block the flow of urine. This can cause swelling in the kidney, causing severe pain, and even kidney damage. Ureteroscopy is used to find the cause of this blockage and remove it.
Who is best suited for this?
This is the most effective treatment for stones in the lower urinary tract, especially near the bladder. It is also a good option for those who are not suitable for other treatments. For example:
- For pregnant mothers
- For those who are overweight (obese)
- For those with blood clotting disorders
Since the risk of open surgery is higher for these people, a method like this without an incision is safer.
How should I prepare before surgery?
This usually doesn't require much preparation, but it's very important to follow your doctor's instructions.
- Fasting: Because you will be under anesthesia, you will be told not to eat or drink anything for 6-8 hours before the surgery.
- Urine sample: You may be asked to provide a urine sample to check for a urinary tract infection before surgery. So be prepared to wait an hour or so before you go to the hospital.
- Tell your doctor about any medications you are taking: If you are taking any special medications, such as blood thinners , be sure to tell your doctor in advance. You may be asked to stop taking them a few days before the surgery.
What to expect after surgery?
After the surgery, you will be observed for a few hours and, if there are no major problems, you will be allowed to go home the same day.
- Going home: Because you are unconscious, you cannot drive a car or take a bus alone. So be sure to bring someone to take you home.
- Preventing Infection: You will be given an antibiotic to take for two to three days to prevent infection. If you develop symptoms such as fever, chills, or increased pain, these may be signs of an infection. If this happens , call your doctor immediately.
- Pain: It is normal to have some pain for a few days after surgery. You may feel a tingling sensation in your lower abdomen and groin. Your doctor will give you painkillers to help control this pain.
These things can help reduce pain and discomfort at home:
- Drink plenty of water: During the first two hours after surgery, drink at least two glasses of water every hour. Drinking plenty of water will help flush out the stone particles and blood faster.
- Hot water bath: With your doctor's permission, taking a hot water bath can help reduce pain and stiffness.
- Warm compresses: Applying a clean cloth soaked in warm water to the urethra can help reduce inflammation. Applying a hot water bag to the area where the kidneys are located can also help relieve pain.
- Urine color: It's normal for your urine to be pink or red in the early days. This means you need to drink a little more water.
What if a stent is placed?
Sometimes, after the stone is removed, the urethra can swell. If this happens, the passageway for urine can become blocked again. To prevent this and help the urethra heal faster, the doctor may place a very thin, flexible tube called a stent inside the urethra.
A stent is not something you should be afraid of. It is a temporary thing. After a week or two, it is removed again in a small procedure. While it is in place, you may feel a little discomfort and the need to urinate more often.
What are the risks of this treatment?
As with any medical procedure, Ureteroscopy carries a small risk, but the likelihood of these occurring is very low.
- Infection
- Bleeding
- Injury to the ureter
Very rarely (about 1 in 1,000 surgeries), the urethra can become severely damaged. If this happens, you may need another surgery to repair it. But remember that these are very rare cases. Your doctor will take all necessary steps to minimize these risks.
Take-Home Message
- Ureteroscopy is a very safe and effective modern treatment method that does not involve any incisions in the body and is used to remove stones from the kidneys and ureters.
- This is done by completely sedating you, so you won't feel any pain during the treatment.
- The pain and discomfort that occurs after surgery usually goes away within a few days. Use the medication exactly as prescribed.
- Drinking plenty of water after surgery is very important for a speedy recovery.
- If you develop a high fever, uncontrollable pain, or other unusual symptoms, notify your doctor without delay.
- Instead of suffering from kidney stones out of fear, talk to your doctor about modern treatments like this and get the right solution.
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