Ureterorenoscopy (Flexible)
Why are you having this operation?
The most common indication for this operation is a stone in the kidney that needs to be treated with laser to break it into fragments that can pass. Occasionally, a flexible ureteroscopy is performed for other diagnostic reasons, to find out if there is an abnormality in the kidney.
What does the operation involve?
Under general anaesthetic, a telescope is passed into the bladder, to allow a soft ‘wire’ to be passed up the ureter to the kidney. This acts as a guide for a smaller telescope (flexible ureteroscope), which is passed alongside the wire, to the kidney, and to the site that needs to be examined or treated. If a stone needs to be treated, it is often broken into small fragments with a laser fibre. These fragments then either pass out, or can be removed with a very small wire basket.
If you are having the procedure for investigation of an abnormality in the kidney, a biopsy may be taken.
Occasionally, a soft plastic stent needs to be left in the ureter for a period of time (days to weeks) after the operation. This is removed later.
After the operation
You will normally be able to go home the same day. Make sure someone can take you home, and stay with you for 24 hours. Sometimes, an overnight stay is required.
Do rest at home until you feel able to get back to functioning normally.
Simple painkillers should be taken for any discomfort. It is common to see a small amount of blood in the urine, and to have some discomfort in the bladder for a short time. If you have a stent inserted, these can irritate the bladder, give some discomfort and make you feel that you need to void frequently.
As stone fragments pass from the ureter to the bladder, you may have some pain. If this is severe, please contact the practice immediately, or go to your nearest emergency department.
If you develop a high temperature, severe pain on passing urine, inability to pass urine or worsening bleeding, please contact the practice immediately, or go to your nearest emergency department.
Potential side effects and complications
All procedures have the potential for side effects. Although these complications are well recognised, the majority of patients do not have problems after a procedure.
Risks of the anaesthetic need be discussed with the anaesthetist who will be looking after you during the operation, and who will visit you beforehand.
There are specific risks with this surgical procedure, and these will be discussed with you before your procedure. As a guide to complement that one-on-one discussion with your surgeon, these include:
Common
- Mild burning or bleeding on passing urine for short period after operation
- Temporary insertion of a bladder catheter
- Temporary Insertion of a stent
- The stent may cause pain, frequency and bleeding in the urine
Occasional
- Inability to retrieve the stone, and the need for a repeat operation to treat it on a second occasion.
- Infection in the urine, requiring antibiotics
- Failure to pass the telescope if the ureter is narrow
- Failure to remove all stones, or recurrence of stones
Rare
- Infection in the kidney (pyelopnehritis) which can be serious and require intravenous antibiotics
- Damage to the ureter with need for open operation to repair it
- If the ureter is damaged, occasionally a tube needs to be placed into kidney directly from the back to allow the leak to heal
- Scar or stricture of the ureter requiring further procedures
Disclaimer
This information is intended as an educational guide only, and is here to help you as an additional source of information, along with a consultation from your urologist. The information does not apply to all patients.
Not all potential complications are listed, and you must talk to your urologist about the complications specific to your situation.
