URSL Surgery - Ureteroscopic Lithotripsy

During

• Anaesthesia: To ensure comfort and a pain-free surgical experience, the patient is administered general anaesthesia.
• Cystoscopy: The doctor inserts the cystoscope through the urethra to visualise the bladder. At first, the right ureteral orifice is identified, and then the guidewire advances towards the right upper ureter.
• Insertion of the ureteroscope: To reach the kidney stone, a flexible ureteroscope is introduced over the guidewire into the right ureter. 
• Identification and fragmentation of the stone: Using laser energy, the stone is fragmented into smaller pieces to facilitate the removal. 
• Stone removal: The fragmented particles of the stone are extracted using specialised forceps. The extraction ensures the complete removal of stone debris and minimises the risk of recurrence or complications. 
• Dj stenting: To reduce the risk of post-operative obstruction, swelling, and urinary reflux and maintain ureteral patency, a Dj stent is placed in the ureter after the removal of the stone

Is a stent mandatory after ureteroscopic lithotripsy

Ureteral stents are inserted to flush out the stones. Stents expand the ureteral passage and allow the stone to move out of the body easily through the ureter. The stent helps to maintain the urine flow, reduces complications, such as swelling or blockage, and promotes healing of the ureter. Depending on your specific medical conditions and the circumstances of your procedure, in some cases, the doctor may use a temporary ureteral stent during or after the ureteroscopic lithotripsy.

URSL Risks

Like any medical procedure, URSL has some risks and potential complications, even though it is generally safe and successful. The primary risks and complications of URSL are listed below.

• Bleeding

Using instruments inside the kidney and ureter during URSL can sometimes cause bleeding.  Usually minor, this goes away on its own, but in rare instances, it may need additional interventions to control.

• Infection

There is a slight chance of bacteria because of the tools in the urinary tract.  Fever, chills, increased pain, or changes in the colour or odour of the urine are some signs of an infection. If an infection develops, prompt antibiotic therapy is essential.

• Ureteral Injury

The ureteral wall may unintentionally sustain damage when devices are inserted and moved inside the small ureter. There is still a chance of ureteral damage, which can necessitate additional care, even if urologists take measures and employ imaging methods to direct their actions.

• Urinary Tract Obstruction

After the URSL, swelling or tiny stone particles may temporarily block the ureter, resulting in symptoms like pain or trouble peeing. A temporary ureteral stent may be implanted in some situations to maintain urine flow until the obstruction clears.

• Residual Stone Fragments

Tiny residual stone particles may still be present in the urinary tract even after successful stone breakup and removal after URSL. These pieces may eventually enlarge or act as locations for repeated stone formation. To guarantee complete stone clearance, additional imaging tests could be advised.

• Allergic Reactions

Although rare, allergic reactions to medications used during URSL, such as anaesthesia or contrast dye, are possible.  To reduce this risk, it’s important to let your healthcare practitioner know about existing allergies in advance.

• Risks Associated with General Anaesthesia

If URSL is carried out under general anaesthesia, there are inherent risks related to the administration of anaesthesia, such as adverse reactions or respiratory issues.