Are you awake during a ureteroscopy?
You may be awake during the procedure. Or you may have medicine to make you sleep. In either case, you will not feel pain.
Ureteroscopy is a minimally invasive method to treat kidney stones as well as stones located in the ureter. It is performed in the operating room with general or spinal anesthesia, and is typically an out-patient procedure (you go home the same day).
Postoperative Pain: Most patients after ureteroscopy experience mild to moderate pain in the flank and/or bladder area. This is generally well controlled by use of oral narcotics (pain medication) such as Percocet or Vicodin.
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.
Stone removal via ureteroscopy usually requires an operating theatre and general anesthetic, in contrast to ESWL, which is typically performed under conscious sedation. Ureteroscopy under local anesthesia was first described by Rittenberg et al in 1987.
You will need to rest for 24 hours. You should have someone stay with you during that time. Your surgeon will likely prescribe medicines for you to take at home. This may include a pain medicine and an antibiotic to prevent infection.
You may need to give a urine sample. This is to make sure you don't have an infection. Before the procedure, a health professional will clean the area around your urethra. He or she will also put numbing gel inside your urethra.
| Size of kidney stones | Chances of passing naturally | Treatment |
|---|---|---|
| 4-7mm | About 60% | Home remedies and painkillers |
| Larger than 7mm | About 20% | Ureteroscopy |
| 1-2cm | Cannot pass | Lithotripsy |
| Larger than 2cm | Cannot pass | Percutaneous nephrolithotomy |
Your Recovery
For several hours after the procedure you may have a burning feeling when you urinate. This feeling should go away within a day.
You will also get a prescription for pain pills. You can use these prescription pain pills in addition to acetaminophen every for hours. Do not exceed 4000mg acetaminophen per day. You may also be given a prescription for tamsulsin (Flomax), this helps relax the urinary system and ease discomfort from the stent.
Do you need a catheter after ureteroscopy?
After the Procedure
Depending on the procedure, you may need a catheter to drain urine. You may also be prescribed pain medication or antibiotics. Urination may be painful or contain blood at first.
The most frequent reason for ureterorenoscopy is the necessity to remove calculi from the ureter and/or kidney. After completing this procedure the Foley catheter is inserted in the bladder.
NO driving a car and limit long car rides for 2 weeks. NO strenuous exercise, limit stair climbing to minimum for 4 weeks. NO severe straining during bowel movements – take a laxative if necessary. DO drink plenty of fluids to keep your urine flow brisk.
Most ureteroscopy is performed effectively and safely in the supine position.
Conclusion: Routine placement of a ureteral stent is not mandatory in patients without complications after ureteroscopic lithotripsy for impacted ureteral stones.
Ureteroscopy produced slightly higher overall quality of patients' life, but produced a significant higher overall cost per quality-adjusted life year (QALY) than shock wave lithotripsy, exceeding the cost-utility threshold (20,000€/QALY). Sensitivity analysis confirmed results in 93.65% of cases.
Your healthcare provider gently pulls on the string to remove the ureteral stent. If you need a ureteral stent for a few weeks or longer, the stent won't have a string. Your provider removes the stent during a minor office procedure. You may get X-rays or an ultrasound before removal.
Following the instructions of your Urologist, you may have a speedy recovery. After a week, you may feel better; you can drive again when you stop taking any narcotic pain reliever.
Diet: You may return to your normal diet immediately. Because of the raw urinary tract surfaces, alcohol, spicy foods, and drinks with caffeine may cause some irritation or frequency of urination and should be used in moderation.
For most operations, you do not need to have the hair around the site of the operation removed.
Can a kidney stone get stuck in your pee hole?
Some kidney stones can't be passed out of your body because they are too large and become stuck in the urinary tract.
At 13.372 centimeters (5.26 inches) long and weighing 801 grams (1.76 lbs) the kidney stone broke two world records when it was removed by Sri Lankan Army doctors on June 1.
Those that are 5 to 7 mm (larger than a pencil erasure but smaller than a green pea) can be passed in 50 percent of cases. Stones that are larger than 7 mm rarely pass without a surgical procedure. There is usually no permanent damage if kidney stones are recognized and treated in a timely fashion.
Some examples of foods that have high levels of oxalate include peanuts, rhubarb, spinach, beets, Swiss chard, chocolate and sweet potatoes. Limiting intake of these foods may be beneficial for people who form calcium oxalate stones which is the leading type of kidney stone.
Pain management
Your doctor may recommend a non-steroidal anti-inflammatory drug (NSAID) like ibuprofen or diclofenac. A warm bath can also help. If your pain is more intense, you may need a stronger painkiller. Your doctor may also give you medication to help make it easier to pass pieces of stone.
