This operation is performed to remove a kidney stone, which has become trapped in the tube between the kidney and the bladder (ureter). The operation is performed under general anaesthetic and the surgeon passes a long telescope (ureteroscope) through the bladder and up the ureter to the level of the stone. A laser fibre is used disintegrate the stone into dust and very small pieces which then pass spontaneously into the bladder and are emptied out with urination. Kidney stones are a common problem and most are small enough to pass on their own. However stones over 5mm in size have more difficulty being passed and in this case a ureteroscopy is performed.
The risks involved include bleeding, infection, pain and a very small chance of damaging the ureter with the telescope. This is uncommon and if it occurs the usual treatment is to place a small silicone surgical tube called a stent between the kidney and the bladder and this allows the hole to repair itself over a period of 6 weeks. The surgery is usually successful, especially if the stone is in the lower half of the ureter. When stones are trapped in the upper half of the ureter sometimes it can be difficult to reach the stone on the first surgery as the ureter can be quite narrow. In this case stents are placed as a temporising measuring to allow the ureter tube to dilate by itself over a period of weeks. The patient then returns for a second session at which time it is usually much easier to pass the ureteroscope up to the stone.
Recovery after the operation is usually quick and patients can often be discharged on the same day as surgery or the following day. Sometimes it is necessary to leave a stent in after successful clearance of a stone owing to swelling or narrowing of the ureter tube. In this case the patient is brought back in 2-3 weeks for a quick procedure to remove the stent under local anaesthetic and can be discharged home immediately afterwards.
Kidney stones can return and patients with multiple stones often need several procedures to clear all stones. Your surgeon will discuss this with you if this is the case.