Ureteroscopy and Laser Treatment of Stones
How are stones in the ureter and the kidney lasered?
A thin lighted tube equipped with a camera, called an ureteroscope, is passed through the urethra and bladder and into the ureter and kidney.
The lower half of the kidney can be access with a rigid ureteroscope and the kidney can be accessed with a flexible ureteroscope.
Once the stone is positioned with the ureteroscope, instruments can be passed through the scope to treat the stone. Very thin laser fibers, diameter ranging from 0.2 to 0.4mm, is used to treat the stone and break it down into very fine fragments of less than 1 mm. These fragments are then flushed out. Alternatively a basket can be used to grasp the stones and allow the stones to be pulled out. This is only used for small stones to ignore damage to the ureter.
What is the success rate of ureteroscopic laser stone surgery?
Because the stone is directly visualize during stone treatment, the stone fragmentation and clearance rate is very high.
What to expect during ureteroscopy and laser stone surgery?
Ureteroscopy is perform though the urethra and no incision is required. Recovery from surgery is fast, and this operation is usually be performed as day surgery. A general anesthetic is required.
The stone can be treated in one session most of the times, sometimes if the ureter is swollen or if the stone is large, more than one session may be required to totally removed the stone. A stent is usually left in the ureter for one week following ureteroscopy to facilitate drainage of urine and passage of fragments. Without a stent, swelling of the ureter after ureteroscopy can cause obstruction and pain.
Most patient will notice some pain and blood in the urine after the operation for a few days. Stent symptoms will persist until the stents removed. Most patients can be expecting to return to full activity one week after surgery.