Do you need antibiotics after ureteroscopy?
In the United States the 2012 AUA guidelines9 recommend
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.
You will see blood in the urine off-and-on until the ureteral stent is removed. This is expected and normal after this procedure. When the urine turns red, limit your activities and drink plenty of fluids. It is normal to experience bladder spasms, flank pain, and blood in your urine while the stent remains.
Based on the recent AUA best practice policy statement, an oral fluoroquinolone or trimethoprim/sulfamethoxazole (TMP-SMX) is the antimicrobial of choice for the peristent removal time period, and a first-generation cephalosporin is an alternative antimicrobial.
Stent pain: About 50% of patients who undergo ureteroscopy and have a stent will have “stent pain,” and this is by far the most common risk/complaint following ureteroscopy.
For several hours after the procedure you may have a burning feeling when you urinate. This feeling should go away within a day. Drinking a lot of water can help. You may have some blood in your urine for 2 or 3 days.
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.
Results: Ureteral stent discomfort, ureteral wall injury and stone migration are the most frequently reported complications. The worst complications include urosepsis, multi-organ failure and death.
You may have bloody urine, possibly with some small clots. You may also have “achy” pain due to ureteral spasms. This generally only last a few hours, but should resolve over the next 2-3 days. Sometimes, mild discomfort can last up to 2 weeks.
Other potential sources of pain include ureteral spasm (7, 8), mucosal irritation, ischemia, inflammation, and activation of chemoreceptors (9, 10). During ureteroscopy, forced irrigation causes distention of the renal collecting system.
Do you need antibiotics after stent?
UPJO can be treated with a surgery called pyeloplasty. A thin tube called a stent may be placed in the ureter for several weeks to help with healing. Antibiotics may be prescribed to prevent a urinary tract infection (UTI) from the stent, but this study found they are not necessary for most children.
After the minor trauma caused by removal of the ureteric stents, a second peak of infectious complications can be observed. Therefore, perioperative empirical antibiotic prophylaxis should be considered to decrease the risk of infectious complications after cystectomy or stent removal.
Stent-associated UTIs may progress to urosepsis. Indeed, in most cases of uro- sepsis, the microorganisms isolated from the patient's blood are the same as those isolated from their urine (Wagenlehner et al. 2013).
Urinary tract Infections, or UTIs, are common after a ureteroscopy, because reusable ureteroscopes can still harbor bacteria even after sterilization.
You may have a small amount of blood in your urine for 1 to 3 days after the procedure. While the stent is in place, you may have to urinate more often, feel a sudden need to urinate, or feel like you can't completely empty your bladder. You may feel some pain when you urinate or do strenuous activity.
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.
There might be some residual soreness and pain, but this should be temporary. Lingering pain after passing a kidney stone could be a sign that you have another stone, an obstruction, or infection. It could also be an unrelated issue. Kidney stones can also cause nausea, vomiting, or blood in the urine.
Post-Surgery Symptoms
discomfort and blood in your urine for a few days, especially if you have a ureteral stent in place, pain and nausea as remaining stone fragments pass through your urinary tract, and. incision and surgical site pain, if your surgery required it.
Conclusion: Routine placement of a ureteral stent is not mandatory in patients without complications after ureteroscopic lithotripsy for impacted ureteral stones.
Water is best. You can also drink ginger ale, lemon-lime sodas, and fruit juices. Drink enough liquids throughout the day to make at least 2 quarts (2 liters) of urine every 24 hours.
Will azo help with stent pain?
Phenazopyridine (Pyridium, AZO)
Most commonly referred to as Pyridium or AZO, this urinary analgesic soothes the urethra if you have a UTI or a trauma from a recent urology surgery. Pyridium for stent relief is a great, safe option.
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).
| 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 |
Mean overall cost was significantly lower for URS ($2801) compared to SWL ($3627) (p = 0.03). The included studies had high risk of bias overall. On sub-analysis, URS was significantly cost-effective for both stones < 10 and ≥ 10 mm and for proximal ureteric stones.
Other studies have shown and now this study shows in the proximal ureter and kidney that we don't necessarily have to do it. Patients probably are going to be symptomatically better without stents, and they seem to do just as well as if we place stents.
