Flexible pyeloscopy means looking into the kidney with a very long thin flexible endoscope. This operation is performed through the urethra and bladder in patients that have problems in the kidneys, including kidney stones or bleeding from a source within the kidney. The procedure is performed under general anaesthetic and lasts between 30-60 minutes depending upon the circumstances.
After the patient is put to sleep a thin wire is passed up the ureter (tube between kidney and bladder), which acts as a safety guide and helps passage of the scope up into the kidney. The surgeon advances the flexible pyeloscope into the kidney and a high definition image in colour is obtained allowing inspection of the entire surface of the kidney. If the patient has problems with kidney stones these can usually be treated with a laser at the time of pyeloscopy and completely broken down to dust. Small fragments can be retrieved with a small urological basket that is passed through the centre of the scope and pulled out for analysis. Sometimes patients have bleeding from a small lesion in the kidney. Sometimes these are cancerous. A biopsy sample can be taken of these lesions through the ureteroscope as well.
The surgery is generally safe but delicate and there is a small risk of causing bleeding, infection and damage to the ureter tube or kidney itself, which is uncommon. Sometimes it is necessary to place a ureteric stent (soft flexible silicone tube) between the kidney and the bladder if there has been bleeding or swelling of the ureteric tube during the procedure. This prevents pain and damage to the kidney after the surgery. The stent can usually be removed within 1-2 weeks after the surgery by which time healing is complete.
Often times patients can be discharged the day of surgery or the following day with an overnight stay in hospital. In the case of multiple kidney stones sometimes repeat pyeloscopy and laser procedures are required to clear all the stones. Your surgeon will discuss this with you prior to commencing any treatment.