The small scopes inserted via the urethra allow the doctor to directly see a stone in the ureter (the tube that connects the kidney to the bladder). Using the scope, the stone can either be broken apart with a laser, removed using a basket or both. Typically, a stent is inserted and left in place for several days while healing takes place.
Potential risks of the procedure include injury to the ureter, development of scar tissue and narrowing of the ureter, infection, and the possibility that the stone will not be completely treated. Most people can return to work within one or two days following the procedure.
Stop all over the counter medications, supplements, and vitamins 7 days prior to the procedure (especially aspirin). If you take any prescription blood thinners, check with the prescribing physician prior to stopping this medication.
Depending on your medical history you may need pre-operative testing such as an electrocardiogram (EKG), blood work, or a clearance by your primary care physician or cardiologist.
Labwork and clearance should be obtained no later than 5 days prior to the day of surgery, if time permits.
Bring ALL films – including X-rays and CT scans to the hospital / surgery center. The surgeon may need to review them prior to your surgery. The procedure typically takes 60-90 minutes depending on the size and location of the stone.
Usually, a stent is left in the ureter following the procedure to allow healing to take place. Because of instrumentation during the procedure, the ureter may become swollen or inflamed. The stent allows urine to drain properly from the kidney to the bladder while the swelling resolves. A string may or may not be attached. You should be very careful not to tug or pull on the string as this could cause your stent to move and become dislodged.
With the stent in place you may have bladder irritation – including going to the bathroom more frequently, burning with urination, back pain, urgency, or bladder spasms. It is common to have some blood in the urine with the stent in place. If the blood in the urine is persistent, thick, or has clots – contact the office. If the pain is severe, you have vomiting, or you have a fever above 101°F – call the office or go to the emergency room.
If a string is attached the stent can typically be removed 3-5 days after surgery, as instructed by your surgeon. The urologist performing the surgery will determine how long the stent should remain in place, and when it can be removed. You may be asked to obtain another X-ray prior to removing the stent.
Call the office immediately or go to the EMERGENCY ROOM if you have any fever above 101°F, chills, severe abdominal pain, or bleeding that does not improve with rest and increased fluids.