Ureteroscopy and laser of stones is an incision-free operation to remove or break up a stone from the ureter by passing a small telescope up the ureter (tube from the kidney to the bladder). Usually a laser is used to shatter a stone but on occasion a stone can be removed in one piece with a basket.
Before your operation
You have a stone visible on x-ray or CT scan that is suitable for removal by ureteroscopy. Your surgeon will discuss this treatment with you and also go over other stone treatment options that are appropriate.
The operation and outcomes will be explained to you by your surgeon. When you feel comfortable that you understand what is to be done and have had all your questions answered you will be asked to sign a consent form. This consent form should be signed by both yourself and your surgeon and forwarded to the hospital at least five days before your admission.
A blood test will need to be performed and a urine sample may need to be taken 4-5 days prior to surgery. Your surgeon will give you a form to take to the laboratory to have these tests done.
An x-ray or CT scan may be performed just before your surgery to check the position of your stone.
If you are over 60, or have other medical conditions, you may also have an electrocardiogram (ECG) to check the health of your heart prior to surgery.
Operation day
On arrival to the hospital, the staff will show you to your bed and guide you through what is required prior to your operation. You should bring all your own medications with you to hospital.
This operation is usually performed under general anaesthesia. The anaesthetist will discuss this with you before the operation. This usually occurs in your hospital room pre-operatively. Just prior to surgery you may be given a premedication tablet to relax you.
The operation
The surgeon passes a small instrument called a ureteroscope through the urethra (water pipe) and bladder into the ureter (tube from the kidney). This is done with the assistance of x-ray screening.
The surgeon then locates the stone and either removes it with a wire basket or shatters it with a laser. A stent (tube) may be left in the ureter for a few days to help the urine and any stone chips to flow out. You may also have a catheter (tube) in your bladder after the procedure.
Expect to go home the same day as your operation. If you have a catheter in your bladder this will be removed before you leave.
After discharge
You will receive a follow-up appointment for 6 weeks after your operation. A letter will also be sent to your own doctor about your operation.
When you get home you should drink twice as much as you would normally to flush your system through and minimise any bleeding. You should aim to keep your urine permanently colourless to minimise the risk of further stone formation.
You may experience pain in the kidney over the first 24-72 hours due to the swelling caused by insertion of the instrument or by the presence of a stent. Anti-inflammatory painkillers will help this pain which normally settles after 72 hours.
If a stent (tube between kidney and bladder) is inserted you will be informed before your discharge when the stent needs to be removed. Stents can be removed by you if a string is attached or by flexible cystoscopy at Urology Associates. Click here for more information on stent removal.
Complications
All procedures have a potential for side effects. You should be reassured that, although all these complications are well recognised, the majority of patients do not suffer any problems after a urological procedure.
- It is common to have blood in the urine.
- If you develop a fever, severe pain on passing urine, inability to pass urine or worsening bleeding you should contact Urology Associates or your GP immediately.
- Small blood clots or stone fragments may travel from your kidney resulting in renal colic. Renal colic may present as intense pain in the side of your abdomen (tummy) which may spread down into the lower abdomen or groin. In this event you should contact Urology Associates any time of the day or night or your GP immediately.