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Ureteroscopy


Why is this procedure done?


Your kidneys make urine that flows through your ureters to your bladder where the urine is stored. The urethra is a tube at the bottom of the bladder. Urine flows through this tube and out of your body when you pass urine. Sometimes, there is a block along the way and urine is not able to leave your body. ‚  
A ureteroscopy is a procedure that lets the doctor see the inside of your ureters, bladder, and urethra to: ‚  
  • Look for and treat stones or unusual growths blocking the ureter
  • Learn more about why you are having blood in your urine
  • Take a tissue sample from the inside of your bladder
  • Learn more about abnormal cells found in a urine sample

There are 2 kinds of ureteroscopes your doctor may use. A flexible one bends and is often used when a stone is suspected in the ureter near the kidney. A rigid scope is more often used for stones in the lower part of the ureter close to the bladder. ‚  

What will the results be?


Most often, the doctor is able to break up any stones seen in the ureter. Your doctor may place a wire tube called a stent to let the stone pass more easily. The results will help your doctor understand what kind of problem you have with your ureter. Together you can make a plan for more care. ‚  

What happens before the procedure?


Your doctor will take your history. Talk to the doctor about: ‚  
  • All the drugs you are taking. Be sure to include all prescription, over-the-counter, and herbal supplements. Tell the doctor if you have any drug allergy. Bring a list of drugs you take with you.
  • Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin, ibuprofen, Aleve (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs for a time before the procedure. Talk to your doctor about them.
  • If you need to stop eating or drinking before your procedure.

Your doctor will do an exam and may order: ‚  
  • Ultrasound
  • Lab tests, such as blood or urine samples

You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home. ‚  

What happens during the procedure?


  • Once you are in the operating room, the staff will put an I.V. in your arm to give you fluids and drugs. Sometimes, the doctor will give you a special drug to make you numb for the procedure. Other times, you are fully asleep.
  • The doctor will put numbing drugs on the skin of your urethra.
  • You will lie on your back on an exam table.
  • Your doctor will put a thin tube called a ureteroscope into your urethra. This tube has a tiny lighted camera on the tip. Your doctor will put saline (salt) water into your bladder through the tube. The doctor will fill it until your bladder wall expands. You may feel bloated, like you need to pass urine. Your doctor will look at the inside of your bladder. The doctor may take a small sample of tissue if it does not look normal.
  • The tube is gently passed into your ureters and may be guided all the way to your kidney if needed.
  • Your doctor may pass small tools through the scope to take out stones or to break them up into smaller pieces. The doctor may also place a stent to help keep your ureter open so urine can drain easily, or so a stone can pass through more easily. If your ureter is small, your doctor may place a stent and leave it in for 1 to 2 weeks to keep it open. Then, a procedure to remove it will be done later.
  • The ureteroscope is slowly taken out of your body when the procedure is done.
  • This procedure will take 1 to 2 hours, based on the reason for your procedure.

What happens after the procedure?


  • You will go to the Recovery Room and the staff will watch you closely.
  • You may feel sore. You may see a small amount of blood in your urine for 1 to 2 days or as long as you have a stent in place. It may also burn when you pass your urine for 1 to 2 days.
  • If the doctor did a biopsy, the sample will be sent for testing.
  • Most often you are able to go home the same day of your procedure.

What care is needed at home?


  • Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
  • Drink 6 to 8 glasses of water a day for the next 2 days, if OK with your doctor.
  • Empty your bladder as soon as you feel the need to. Dont put off going to the bathroom. It stretches and weakens the bladder.
  • Avoid drinking beer, wine, and mixed drinks (alcohol).
  • You may feel like you need to pass urine more often if you have a stent in place. This is normal.

What follow-up care is needed?


  • Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.
  • If you had a biopsy, ask the doctor when you can get the results.
  • If your doctor placed a stent, you will need to have this taken out in 1 to 4 weeks. This is often done in the doctors office.

What lifestyle changes are needed?


  • Talk to your doctor about when you may go back to your normal activities like work, driving, or sex.
  • You should be able to eat your regular diet after the procedure. Ask your doctor about eating after your procedure.

What problems could happen?


  • Bleeding
  • Infection
  • Injury to the kidney, ureter, bladder, or urethra

When do I need to call the doctor?


  • Signs of infection. These include a fever of 100.4 ‚ °F (38 ‚ °C) or higher, chills, pain with passing urine.
  • Pain does not go away, even with drugs
  • Urine is bloody or cloudy
  • Little or no urine

Helpful tips


  • Ask your doctor if you can take a warm bath to help with soreness or burning.
  • Ask your doctor if it is OK to place a clean, warm damp washcloth on the area to help with soreness or burning.

Where can I learn more?


National Kidney Foundation ‚  
http://www.kidney.org/atoz/content/kidneystones_Ureteroscopy.cfm ‚  
National Kidney and Urologic Diseases Information Clearinghouse ‚  
http://kidney.niddk.nih.gov/kudiseases/pubs/cystoscopy/ ‚  

Consumer Information Use and Disclaimer


This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚  

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