Ureteroscopic lithotripsy (URSL) – Kidney Stones Treatment
What is Ureteroscopy?
Ureteroscopy (URS) is a preferred method for the treatment of small- to medium-sized kidney stones located in any part of the urinary tract.
The procedure is typically performed with the patient under general anesthesia (asleep).
- During this procedure, a ureteroscope is inserted through the urethra and bladder into the ureter (a tube that carries urine from the kidneys to the bladder) or kidney.
- X-ray images with a contrast agent (dye) in the ureters may be used to allow the urologist to see where the stone is located and to rule out other abnormalities.
- The ureteroscope is long and thin with a tiny fiber-optic camera at the end that is used to see beyond the bladder into the ureters.
- Once the stone is located, it is pulled out directly with a “stone basket” or a laser is used to break the stone into smaller pieces before they are extracted using the basket.
- Some ureteroscopes are flexible like thin and long straw. Some are more rigid and harder.
In most cases, a urethral stent (a piece of surgical plastic that goes from the kidney to the bladder through the ureter) will be placed at the end of the procedure.
The stent keeps the ureter open following surgery. If a stent is not placed the ureter may temporarily swell shut or become occluded by blood clots or stone debris resulting in kidney pain following surgery.
In a small number of cases (less than 5%), the ureter is too narrow to safely permit the passage of the ureteroscopy into it. When this occurs a urethral stent is placed and stone removal is delayed one to two weeks. The stent gently stretches the ureter allowing safe passage of the scope at a later date.
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