Ureteroscopy refers to a ureteroscopy. It is suitable for both diagnostic and therapeutic purposes.
What is ureteroscopy?
In most cases, ureteroscopy is performed to remove urinary stones or kidney stones. Ureteroscopy is also known as ureteroscopy. When the renal pelvis is also evaluated, physicians refer to it as ureterorenoscopy. It is used for urological evaluation of the ureter and is one of the routine medical procedures in urology. Ureteroscopy is an endoscopic procedure. Thus, different endoscopes are used for ureteroscopy. The special ureteroscopes are either flexible, semi-rigid or rigid. The diameter of the narrow medical instruments is between 2 and 4 millimeters. In addition, the endoscopes have a working channel, an irrigation channel and a light guide including optics. Semi-rigid mini-ureteroscopes are considered particularly suitable for ureteroscopy.
Function, effect, and goals
Ureteroscopy can be used for diagnostic purposes as well as for therapy. In most cases, ureteroscopy is performed to remove urinary stones or kidney stones. Stone debris resulting from ESWL (extracorporeal shock wave lithotripsy) is also removed from the organism by ureteroscopy. Diagnostically, ureteroscopy is useful if the patient suffers from narrowing of the ureters, or to rule out renal pelvic tumors and ureteral tumors. Indications for ureteroscopy include endourological urinary stone therapy, taking a tissue sample for histological examination, taking a urine sample or flushing fluid to perform cytological examination, and clarification of imprecise masses in the ureteral area and renal pelvic cavity system. Other possible applications include the treatment of ureteral and renal pelvic stenosis, the clarification of unclear bleeding in the upper urinary tract and local treatment of superficial tumors in the ureteral and renal pelvic cavity. Before ureteroscopy begins, the patient is given a general narcotic. The procedure is usually performed as an inpatient, but can also be performed as an outpatient. To perform a ureteroscopy, a rigid or flexible endoscope is advanced into the ureter via the urethra and urinary bladder. During this procedure, the attending physician always has visual control via a connected monitor. X-ray control is also usually performed. In this way, the physician has access to all important image information during the minimally invasive procedure. Ureteroscopy is usually performed by an experienced urologist. In some cases, it may be necessary to dilate the orifice of the ureter. In addition, it is often useful to inject a contrast medium. This allows an improved orientation over the ureteral area. Obstructions can also be easily identified with this method. If the urinary bladder cannot be passed, which may be the case due to an enlarged prostate, it is punctured through the abdominal wall to create an access. At the end of the examination, the urologist inserts a ureteral stent. Unless there are complications, the splint is removed after 48 hours. The goal of most ureteroscopies is to remove existing ureteral stones or kidney stones from the body. Kidney stones affect about 15 percent of all male patients and 5 to 10 percent of all women. If the stones lead to a blockage of the urinary tract, this can result in considerable pain. Normally, the stones pass out of the organism naturally. However, if this does not happen, ureteroscopy is required to remove them. Typical indications for ureteroscopy are larger-than-average stones that are stuck in the ureter or urine stasis in the direction of the kidney. After the ureteroscope is inserted, the blocking stone is broken into smaller pieces. A shock wave generating laser is usually used for this purpose. A tiny grasping forceps, which is part of the ureteroscope, is used to remove the resulting smaller stone fragments from the ureter. By crushing and removing the kidney or urinary stones, the patient regains freedom from pain.
Risks, side effects and dangers
Occasionally, ureteroscopy may also be associated with certain risks. However, complications such as infection, scarring ureteral stricture, or injury to the ureter occur very rarely. Other complications may include fever, perforation of the ureter, or ureteral avulsion. The development of a stenosis (narrowing) is also considered conceivable, which in turn must then be treated. It is important to be fully informed by the physician about possible complications and side effects. Furthermore, there are certain contraindications. For example, ureteroscopy must not be performed if the patient suffers from blood clotting disorders or a urinary tract infection. These contraindications can be identified by a preliminary examination. Another contraindication is the presence of obstructions to passage, which may include stenosis. Treatment with an endoscope should then be avoided because of conceivable complications. After a ureteroscopy has been performed, the patient is observed for a while. This also applies if the procedure is performed on an outpatient basis. On the day of the ureteroscopy, a sonography (ultrasound examination) and an X-ray are performed. The complete removal of the stones is checked. To prevent stones from forming again, the patient must drink more than 2.5 liters of fluid a day and get plenty of exercise. Drinking also helps to flush germs that have been carried into the urinary bladder out of the body. If unexpected side effects occur after ureteroscopy, such as severe pain, fever, urinary retention or bleeding, a doctor should be contacted quickly. Follow-up after ureteroscopy should be strictly adhered to.
