What you need to know about:

Ureteroscopy/Ureterorenoscopy (URS)

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Recovery Period:

Same day discharge

Permanence:

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Time it takes:

1-3 hours

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Anesthetize:

General Anesthesia

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Overview of

Ureteroscopy/Ureterorenoscopy (URS)

in Thailand

Ureteroscopy, also known as ureterorenoscopy, is a procedure in which a small, flexible scope (ureteroscope) is inserted through the urethra into the bladder and ureter to diagnose and treat urinary tract problems, including stones. The stone may be removed without making an incision.

Goals of

Ureteroscopy/Ureterorenoscopy (URS)

The procedure is performed to remove large stones from the ureter. Ureteric stones or calculi are found in 10% of the world’s population, making them fairly common. They occur when kidney stones move into the ureter, which connects the kidney to the bladder. Ureteric stones can cause acute and severe pain. Small stones will leave the body through urine, but larger ones can cause swelling of the kidneys (hydronephrosis). If untreated, the kidney may be lost.

Price of

Ureteroscopy/Ureterorenoscopy (URS)

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Pros and cons of

Ureteroscopy/Ureterorenoscopy (URS)

Pros

-Ureteroscopies can treat stones located at any position in the ureter and kidney.

-A ureteroscopy allows the treatment of stones that cannot be seen on an x-ray. Certain patients who cannot be treated with ESWL or PERC, such as those who cannot safely stop taking blood thinners, women who are pregnant, and the morbidly obese, can be treated by ureteroscopy.

Cons

-Risk for urethral injury

-The procedure is not ideal for patients who present with large stones

-The procedure is not suitable for patients who have undergone bladder reconstruction

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How it works:

Ureteroscopy/Ureterorenoscopy (URS)

The ureteroscope will be inserted through the urethra into the bladder and up to where the stone is in the ureter. The stone will be grasped with tools or broken up with an ultrasonic/electro hydraulic probe. Once the stone is removed, a catheter or double-J stent will be placed temporarily.

Preparation before

Ureteroscopy/Ureterorenoscopy (URS)

Pre - treatment

A physical examination will be performed along with X-ray and ultrasound if needed. Certain medications especially anticoagulants and blood thinners like aspirin may have to be discontinued at least 1 week before surgery. The patient should inform the doctor of all medications, supplements, and herbal supplements they are regularly taking. If you have a urinary tract infection, the doctor may treat the infection with antibiotics before performing the procedure. You will have to avoid all food and water for 6-8 hours before the procedure or as recommended by the doctor.

Recovery after

Ureteroscopy/Ureterorenoscopy (URS)

Post - treatment

You may see small amounts of blood in the urine. This problem should resolve within a few days following the procedure. Unless contradicted you should drink 2 liters of clean water each day to prevent infection. You may have some pain which should be relieved by simple analgesia. The patient should inform the doctor right away if you have signs of infection or any of these symptoms: fever, offensive smelling urine, worsening pain on urination, severe pain or bloody urine that lasts more than 2-3 days.

Risks & side effects

Discomfort where the ureteroscope was inserted, which should go away after a couple of days. Local anesthesia may be given to ease your discomfort. Infection of the urinary tract, which is uncommon as antibiotics are often prescribed. Long-term complications include spasm of the ureters, which is found in less than one percent of patients.

FAQs:

Ureteroscopy/Ureterorenoscopy (URS)

What are the recommendations for travel for this procedure?

If you are taking any blood-thinning medication/anticoagulant, please let your doctor know as some may need to be stopped before you travel for the procedure. Travelers to Thailand should plan to stay in the country for at least two to five days after the procedure, depending on their condition after surgery, or for the entire duration of treatment. If you plan to return home after the procedure, please speak to your doctor before making travel arrangements. There are no restrictions for air travel. During your follow-up appointment your medical team will assess your health and your incision and you will receive documents detailing your medical and treatment history and your "Fit to Fly" certificate (if needed).

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What are the Risk Factors for Developing Ureteric Stones?

-Genetics. -Not drinking enough water. -Chronic urinary tract infections. -Eating foods that contain substances that cause particles to form in the urine in large amounts.

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Why do I need to have ureteroscopy?

Your healthcare provider may suggest ureteroscopy if you have one or more of the following conditions: -Blood in the urine. -Blockage of the ureter and/or kidney (from stones and tumors).

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