Ureteroscopic Stone Retrieval

Ureteroscopic stone retrieval

Ureteroscopic stone removal is a minimally invasive endoscopic surgical technique to remove stones in the ureter (passage leading to the bladder, connecting the kidney to it) and occasionally in the kidney.

Who Needs This Procedure?

Ureteroscopic stone removal is indicated in case:

• Stones are 5–20 mm in size
• Stone is inflicting heavy pain, infection or obstruction.
• Stone does not succeed with medicines.
• ESWL (shockwave therapy) has been unsuccessful.
• The stones are located in the lower or mid ureter.

Advantages

• No incision or stitches
• High success rate (>90%)
• Appropriate with the majority of stones in the ureters.
• Quick recovery

Ureteroscopy stone removal

A ureteroscope is a thin telescope that is inserted in the urethra lead to the bladder and ureter in order to view the stone directly. The stone is then:

• Removed with a basket /forceps, or
• Lithotripsy: Laser is used to break it and fragments removed.

Procedure

• Type of anaesthesia: General or spinal anaesthesia. 
• Access: Ureteroscope into natural urinary tract.
• Stone localization: Stone is directly visualized.

Stone removal:

• Stones small stones → basket retrieval.
• Big rocks → laser cutting and excavation.
• Stent insertion: DJ stent can be done when necessary.
• Time: 30–60 minutes

After the Procedure

• Stay at hospital: same day or 24 hours.
• A few days of pain or burning during urination, mild.
• Blood-tinged urine 1-2 days.
• A general normal activity was maintained 2-3 days later.
• Stent removal after 5–14 days

Precautions & Aftercare

• Drink plenty of fluids
• Full prescribed drugs.
• No heavy activity before stent removal.
• Adhere to stone-based diet.

Ureteroscopy stone retrieval recovery

The post-operative course after ureteroscopy (URS) is characterized by a rapid recovery as it is minimally invasive and there are no incisions.

First 24 Hours (Immediate Recovery)

• Inpatient: 24 hours/Same day. 
• Light abdominal or lateral pain.
• During urination, burning is frequent.
• Pink or blood urine 24- 48 hours
• Both a frequency of urination greater, particularly when a DJ stent is inserted.

First Week After Procedure

• The reduction of pain is expected to decrease in 2-3 days.
• Gently related symptoms of stents might remain:
• Urgency to pass urine
• Flank pain during urination, mild.
• Light movement in 2-3 days. 
• Exercise is strenuous and heavy lifting is to be avoided. 

Stent-Related Recovery

If a DJ stent is placed:

• Light back pain or discomfort is usual.
• Medications do improve the symptoms.
• Removal of Stent normally takes 5-14 days.
• The majority of symptoms fade shortly after the removal of stents.

Drugs in the Recovery Period

• Antibiotics (to prevent the infection)
• Alpha-blockers (in case of prescribed ureters) (to decrease spasms in ureters)

Food & Liquid Intake

• Drink 2.5–3 liters of water per day.
• Eat less salt and fewer processed foods. 
• Take dietary information (stones) as needed.

When Can You Return to Work?

• Desk work: 2–3 days
• Physically strenuous labor: 5-7 days.
• Full normal routine: 1 week

Long-term Recovery and Prevention

• The imaging of the stones should be followed up to ensure that they have been cleared.
• Metabolic analysis in case of a recurrence of stones.
• Preventive lifestyle and diet change.

Ureteroscopic stone retrieval complications

Ureteroscopic stone retrieval (URS) is a safe and frequently practiced operation. Majority of the patients recover without any issues and just as with any medical procedure, certain complications may arise.

Common & Mild Complications

These tend to be transitional and are cured by medication:

• Burning during urination
• 24-72 hours of blood in urine (hematuria)
• Frequency or urgency of urine.
• Abdominal or flank pain at the lower part.
• Symptoms of DJ stents (pain, urgency, backache)

Moderate Complications

Since less frequent, and may need medical intervention:

• Urinary tract infection 
• Fever or chills
• Persistent pain
• Prolonged hematuria
• Stone pieces abandoned (possibly require repeated care)

Uncommon yet Severe Complications

Rare among seasoned surgeons:

• Ureteric perforation or injury.
• Narrowing of the ureters (stricture).
• Sepsis (severe infection)
• Ureter avulsion (extremely rare)
• Bleeding that has to be intervened.

Stent-Related Complications

If a DJ stent is placed:

• Bladder irritation
• Pain during urination
• Hematuria after activity
• Stent migration (rare)
• Stent that was left behind (prevented by removing it on time)

Best hospital for ureteroscopic stone retrieval India

• Artemis Hospital, Gurgaon
• Medanta-The Medicity, Gurgaon
• Fortis Memorial Research Institute, Gurgaon
• Max Hospital, Saket

Conclusion

Ureteroscopic stone removal is a minimally invasive, effective and safe treatment of ureteric stones. It has a high rate of stone-clearance, fast relief in symptoms, and rapid recovery without any surgical incisions. The complications that occur are mostly mild and temporary and are easily treatable through proper medical attention and follow-up. Ureteroscopy is also an effective procedure that offers good results with the right patient choice, surgical skill, and good post-operative care being hydration, medications and timely removal of stents to ensure that the patient is back to normal activities within a short time.

Ureteroscopic stone retrieval India GetWellGo

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FAQ

Is the ureteroscopic stone removal surgery painful?

• No. The operation is performed under general or spinal anaesthesia. It may take a few days afterwards with mild discomfort or burning in the course of urination.

Is DJ stents is placed in everybody?

• Not always. Stent is inserted when there is swelling in the ureters, huge stone burden or prolonged operation.

Does this patient have blood in urine after Ureteroscopy?

• Yes. Mild blood in urine, 1-2 days, self-limiting 

When is the stent removed?

• DJ stents are typically taken off by 5-14 days based on healing.

Can stones recur following Ureteroscopy?

• Yes. Recurrence of stones can be attained without changes in lifestyle and diet.

How do I prevent stones from coming back?

• Adequate hydration, diet modifications based on stone type and regular follow up with your physician can prevent recurrence.