Ureteroscopy With Laser Lithotripsy
We will perform ureteroscopy with laser lithotripsy while you are under general anesthesia . Over the course of about one hour, we will:
After a brief observation period, you will be able to go home that same day.
*Around five percent of the time, the ureter is too narrow for the ureteroscope. If this happens to you, we will leave a stent in place to dilate your ureter. We will reschedule your procedure for two to three weeks later.
Preventing Future Kidney Stones
Having one kidney stone means you might develop kidney stones in the future. Here are some steps you can take to help prevent kidney stones from forming:
- Drink about 2-1/2 liters of water per day unless a doctor advises otherwise. How much water each person needs may vary.
- Maintain a low-salt diet.
- Limit animal protein to 6 to 8 ounces a day.
- Lower sugar consumption.
- Include plenty of fruits and vegetables in your daily diet.
- If you take a vitamin C supplement, make sure its less than 1,000 milligrams per day.
If you have a history of kidney stones, a dietician can review your eating habits and provide specific dietary tips that can help lower risks of kidney stones.
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What Is A Stent
A stent is a small hollow tube that is placed into the ureter. Its flexible and approximately 10 inches in length.
When placed in the ureter, the top portion of the stent has a small curl that sits in the kidney and the opposite ends curls in the bladder.
Stents may have a string on the end that is visible outside the body. Not all stents have a visible string.
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Bleeding After Ureteroscopic Stone Removal
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I had surgery about 3 days ago they told me its normal for bleading for few days as long as after few days, pee should be pinkish color but if I bleed thick with chunks then I have to call DOC right away and yes it burns really bad but im hoping it would slow down soon
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What The Doctor Does
Doctors first ask questions about the persons symptoms and medical history and then do a physical examination. What they find during the history and physical examination often suggests a cause of the blood in the urine and the tests that may need to be done can make urine appear pink, red, or brown, depending on the amount of blood, how long it has been in the urine, and how acidic the urine is. An amount of blood read more ).
Doctors ask how long blood has been present and whether there have been any previous bleeding episodes. They ask about fever, weight loss, or symptoms of urinary blockage, such as difficulty starting urination or inability to completely empty the bladder. Pain or discomfort is an important finding. Burning during urination or dull pain in the lower abdomen just above the pubic bone suggests a bladder infection. In men, mild to moderate pain in the lower back or pelvis is often the result of a prostate infection. Extremely severe pain is usually due to a stone or a blood clot blocking the flow of urine.
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Does The Patient Need Anesthesia
Yes, even though there is no incision, there will be pain. You and your doctor will discuss whether light sedation and local or general anesthetics will be used. The choice depends on the technique, the type of stone and the patient. SWL can be delivered with just mild sedation, but in general, some type of anesthesiaeither local, regional or generalis used to help the patient remain still, reduce any discomfort, and this improves the breaking of the stone.
Can Dehydration Cause Blood In Urine
While dehydration is less likely to be a direct cause of blood in the urine, it can lead to conditions that can cause hematuria. For example, low urine volume due to consistent dehydration can lead to kidney stones that can cause blood in urine. Dehydration may also be a contributor when extreme exercise causes blood in the urine.
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Ureteroscopy And Laser Lithotripsy
Kidney stones affect 1 in 500 Americans each year, causing significant pain and healthcare expense.
Surgical options for patients with symptomatic kidney stones include extracorporeal shock wave lithotripsy , ureteroscopy, and percutaneous nephrolithotomy . Your renal anatomy, stone composition, and body habitus all play major roles in determining outcomes and operative approach.
The role of ureteroscopy over the last ten years has undergone a dramatic evolution, due to improvements in the ureteroscope size and deflection capabilities, video-imaging, miniature baskets and instruments, and in lithotripsy with the advent of holmium laser. Over 25% of all kidney stone surgeries are now done using small ureteroscope technology.
How Do Health Care Professionals Perform Cystoscopy Or Ureteroscopy
A urologist can perform your cystoscopy during an office visit, in an outpatient center, or at a hospital. Ureteroscopies are usually performed in an operating room under anesthesia. A simple exploratory procedure takes about 15 to 30 minutes, including preparation. The procedure can be longer if your urologist performs additional work like taking a biopsy or removing stones from the bladder or ureters.
An anesthetic gel may be applied around the urethral opening, or a local anesthetic may be injected into the urethra.
Sedatives and general anesthesia are often given for a
- cystoscopy to inject material into the wall of the urethra or ureters
- cystoscopy to inject medicine into the bladder
Sedation helps you relax and be comfortable. General anesthesia puts you into a deep sleep during the procedure.
The health care team will monitor your vital signs and make you as comfortable as possible.
The urologist will position you and make sure the anesthesia is working. The urologist will then gently insert the cystoscope into your urethra and slowly guide it to the bladder. A sterile liquid called saline will be used to slowly fill the bladder, so the urologist has a better view of the bladder wall. As the bladder fills with liquid, you may feel some discomfort and the urge to urinate. The urologist may remove some of the liquid from the bladder during the procedure.
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How Long Does A Foley Catheter Stay In After Surgery
It is a thin tube that drains urine from the bladder. The catheter is held in place by a small water-filled balloon inside your bladder. You may have the catheter in for 1 day or longer. Your surgeon will decide after the surgery.
Is it normal to have blood in urine after catheter insertion?
Finding blood in your urine after catheter insertion is a common complication of intermittent catheterization. Although intermittent catheterization has its side-effect, it still gives users a wide range of benefits such as increased independence and lower rates of infections compared to indwelling catheters.
Can a Foley catheter be used as a stent?
In order to overcome these problems, stents with antireflux mechanisms are produced, however these new stents comes with higher costs compared to conventional stents. Foley catheters are the hands and feet of all urologists and insertion of a foley catheter can easily keep the bladder pressures as low as required.
Percutaneous Nephrolithotomy And Nephrolithotripsy
A doctor may recommend these surgeries for people with large or irregularly shaped kidney stones.
Both surgeries begin after a person receives general anesthetic. To access the kidney, a surgeon makes a small incision in the back and inserts a nephroscope, which is a small fiber-optic camera.
If the surgeon removes the kidney stone through a tube, they are performing a nephrolithotomy procedure.
A nephrolithotripsy procedure, on the other hand, involves breaking down the kidney stones with sound waves and removing the fragments with a suction device.
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What Are The Symptoms Of Kidney Stones
If you have a small kidney stone, it may travel out of your body through your urine . You may not have any symptoms and may never know that you had a kidney stone.
If you have a larger kidney stone, it may get stuck in your urinary tract and block urine from getting through. You may notice symptoms, including:
- Pain while urinating
- Sharp pain in your back or lower belly area
- Stomachache that does not go away
- Feeling sick to your stomach or throwing up
- A fever and chills
- Urine that smells bad or looks cloudy
You may feel a lot of pain when you pass a kidney stone or if a large kidney stone blocks the flow of your urine.
If you are having any of these symptoms, contact your doctor.
What Is A Kidney Stone
A kidney stone is a hard, crystalline mineral material formed within the kidney or urinary tract. Kidney stones are a common cause of blood in the urine and often severe pain in the abdomen, flank, or groin. Kidney stones are sometimes called renal calculi.
The condition of having kidney stones is termed nephrolithiasis. Having stones at any location in the urinary tract is referred to as urolithiasis, and the term ureterolithiasis is used to refer to stones located in the ureters.
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What Are The Side Effects Of A Ureteral Stent
Possible Side Effects of Stents
- Blood in the urine . This can be tea-colored, pink or bright red you may even notice some clots.
- Pain. There can be flank, side or back pain due to the stent.
- Urinary urgency and frequency. You may notice you have to urinate very quickly and very often.
- Burning with urination.
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Pain After Kidney Stone Removal And Stent Symptoms:
Signs and symptoms after kidney stone removal and stent also depend upon the duration for which the stent is allowed to be present inside the kidneys.Signs and symptoms can therefore be differentiated into minor and major:
When the patient urinates, he/ she may feel slight tugging or stretching in the back especially at the end of urination.In persons who are skinny or overweight, the stent may get pushed over the adjacent nerves. Irritation of nerves can cause a burning-like pain or sensation in the back or thighs.
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Pain After Kidney Stone Removal And Stent Treatment:
Renal colic or abdominal pain after kidney stone removal and stent can be managed with adequate fluid intake, analgesics along with anti-inflammatory and antibiotics to prevent urinary tract infection.If the pain becomes unbearable or if the signs and symptoms become severe, the prompt treatment is to remove the stent in-situ.Keeping the DJ stent inside the kidneys for long durations can create major complications like:
Since all stents are prone to degradation effects, especially if the urine is acidic, the ideal duration to remove or replace the stent is 2-4 months.
What Happens After Ureteral Stenting
Someone should drive you home when your provider says its safe to go. Your provider may recommend drinking lots of water after the procedure to help with kidney and bladder function.
You may notice some blood in the urine and have some discomfort. These symptoms are normal after the stent placement and should gradually improve in a couple of days. However, you may see traces of blood and have discomfort until your provider removes the stent. You may also experience frequent urination and pain in the kidney that gets worse when you urinate as long as the stent is in place. The blood in your urine may come and go randomly.
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What Happens During A Ureteroscopy
Once the anesthesia takes effect and youâre asleep, your urologist will insert the tip of the ureteroscope into your urethra .
Once the ureteroscope is in the bladder, your urologist releases a sterile solution through the tip of the scope. This fills the bladder so its walls can be seen more clearly. They then gently guide the scope into a ureter. If there is a concern about a kidney, the scope can be moved all the way up into that organ.
It may take up to 30 minutes for them to observe your urinary tract. If a procedure is done to remove or break up a stone, or to take a tissue sample for a biopsy, the ureteroscopy may take longer.
A ureteroscopy that uses a laser to break up small kidney stones may take about 90 minutes. The type of laser used with the ureteroscope is called a âHolmium laser.â A similar procedure uses a tiny basket at the end of the scope to grab and remove a stone.
Kidney Stent Side Effects
The kidneys connect to the bladder with a small tube called a ureter. Some medical conditions, such as kidney stones, can cause an obstruction in the kidney or the ureter. Kidney stents, also called ureteral stents, are thin, flexible, hollow tubes placed into the ureter to bypass the obstruction and allow the passage of urine. One end of the stent opens into the kidney and the other end opens into the bladder. The stent is not permanentthe urologist removes it after the obstruction is resolved. The procedure is relatively safe, but some side effects or complications may occur.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
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How Do Uric Acid Stones Form
If you have high levels of uric acid, then crystals start to form. These uric acid crystals combine with other substances in your body and create a solid mass. The mass keeps growing. It may stay in the kidney or move down the urinary tract and settle in the ureter.
If the stones are very small, they may pass out of your body in your urine without too much pain. But if they dont pass, they cause urine to back up in the kidney, ureter, bladder or urethra. Thats when you get pain and other symptoms.
How Long Does Ureteroscopy Surgery Take
Ureteroscopy is typically performed under general anesthesia, and the procedure usually lasts from one to three hours. If the stone is small, it may be snared with a basket device and removed whole from the ureter.
How long will my kidney hurt after stent removal?
What can I expect after removal of the stent? You may have bloody urine, possibly with some small clots. You may also have achy pain due to ureteral spasms. This generally only last a few hours, but should resolve over the next 2-3 days.
Should you go to the hospital if you pee blood?
If you ever experience blood when you urinate, you should see a doctor immediately. Thats because most cases of gross hematuria are typically linked to cancer or other issues that require immediate medical care.
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Reasons For The Procedure
The primary advantage of lithotripsy is that it is completely non-invasive.
Lithotripsy is well suited to patients with small kidney stones that can be easily seen by x-ray.
When kidney stones become too large to pass through the urinary tract, they may cause severe pain and may also block the flow of urine. An infection may develop. Lithotripsy may be performed to treat certain types of kidney stones in certain locations within the urinary tract.
There may be other reasons for your doctor to recommend lithotripsy.
Risks Of The Procedure
You may want to ask your doctor about the amount of radiation used during the procedure and the risks related to your particular situation. It is a good idea to keep a record of your past history of radiation exposure, such as previous scans and other types of X-rays, so that you can inform your doctor. Risks associated with radiation exposure may be related to the cumulative number of X-ray examinations and/or treatments over a long period of time.
Complications of lithotripsy may include, but are not limited to, the following:
- Bleeding around the kidney
- Obstruction of the urinary tract by stone fragments
- Stone fragments left that may require more lithotripsies
Contraindications for lithotripsy include, but are not limited to, the following:
- Pregnant patients
- Patients on “blood thinners” or patients with bleeding disorders. Aspirin or other blood thinners must be discontinued for at least 1 week prior to lithotripsy.
- Patients with chronic kidney infection, as some fragments may not pass, so the bacteria will not be completely eliminated from the kidney.
- Patients with obstruction or scar tissue in the ureter, which may prevent stone fragments from passing.
- Patients who require immediate and/or complete clearance of stone material.
- Patients with stones composed of cystine and certain types of calcium, as these stones do not fragment well with lithotripsy
Obesity and intestinal gas may interfere with a lithotripsy procedure.
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