Choosing the most appropriate method for treating nephrolithiasis depends on the size of the calculi, their location, and the patient's condition, which includes one of these three methods: (1)


  • Drinking plenty of water in addition to some medications to facilitate the passage of small calculi.
  • Lithotripsy by Shock Waves.
  • Lithoscopic or Surgical Lithotripsy.


Lithotripsy by Ureteroscopy

Ureteroscopy is one of the methods used to treat kidney stones. It is a simple procedure performed under general anesthesia and uses a endoscope that is inserted through the urethra into the ureter and kidney to remove the calculi. Depending on their size, they can be removed whole if they are small or broken up with a laser if they are large, or if the ureter is narrow and causes blockage, then the broken calculi are extracted after fragmentation. (2)



Indications for using Lithotripsy by Ureteroscopy

Lithotripsy by Ureteroscopy is a method preferred for cases that are not suitable for the method of Lithotripsy by Shock Waves outside the body, such as pregnant women, obese patients, patients with coagulation disorders, or those who have calculi that are difficult to remove by other methods. (3)


However, Lithotripsy by Ureteroscopy is not considered appropriate if the size of the calculi (more than 20 mm) as makes it difficult for the endoscope to remove them, or if there are defects or narrowing in the ureter or bladder, and the doctor is forced to extract them surgically in this case. (4)



How is Lithotripsy by Ureteroscopy performed?


The operation lasts approximately one to two hours, performed under general anesthesia, and its steps include: (5)(6)


Preparing for the operation

The surgeon responsible for the operation gives a set of instructions to prepare for it, including:


  • Fasting the night before the operation.
  • Stop smoking.
  • Stop using some medications that affect the results of the operation.


Procedure Steps

The steps of the Lithotripsy by Ureteroscopy procedure include the following:


  • Administration of general anesthesia.
  • Injecting contrast into the bladder and ureter for better vision.
  • Passing the endoscope through the urethra to the bladder, reaching the ureter and kidney.
  • Fragmenting the calculi using laser or hydraulic beams through the endoscope and connecting a small metal basket to collect the stones and removing them all at once.
  • In some cases, a temporary stent is installed internally in the ureter to expand it and facilitate the exit of the remaining stones through the urine.
  • There are no wounds or surgical incisions in the entire procedure.


Post-operatively

After the procedure is completed, the patient is sent to the recovery room until his condition stabilizes, then he can either return home, or stay overnight under observation as a precaution.


The doctor gives a set of instructions to speed up recovery after the procedure, including:


  • Use analgesics and any other medications as prescribed.
  • Avoid physical exertion and heavy lifting for several days.
  • If a ureteral stent is installed, the doctor sets a date to remove it after approximately 1-2 weeks.
  • Follow-up visits on time after the operation.





At Al-Ahli Hospital, we offer you the Lithotripsy by Ureteroscopy procedure, which is an advanced, safe and successful procedure, performed by our expert doctors in the Nephrology Clinic to ensure that you get rid of kidney calculi completely and permanently!




Side effects of Lithotripsy by Ureteroscopy

You may feel some side effects after Lithotripsy by Ureteroscopy, such as: (1)(5)


  • Mild to moderate pain.
  • Hematuria for a few days, especially if a stent is installed.
  • Nausea and discomfort when the remaining calculi pass.
  • Constipation.


In rare cases, some complications may occur, such as: (5)


  • Infection.
  • Ureteral stenosis.
  • Injury to any part of the urethra.
  • Infection.
  • The need to install a stent for a long period.


 References