menu
FR | EN
Medical assistance
Certified Medical Tourism ProfessionalBest Medical Travel Agency 2015Best use of technology in Medical Travel 2017

Ureteroscopic Stone Removal

03/06/2015

URETEROSCOPIC STONE REMOVAL


What is a urinary tract stone? Waste products (from the food we eat) that usually dissolve in water are eliminated from the human body in the urine. If there is a lack of solvent (urine) or an excess of solute (the waste product the kidney stone is made of, eg. calcium, uric acid, oxalate, etc), then a supersaturated solution occurs. The solute settles (crystallises) out of the solution, in the kidney and forms a stone. Urine normally has chemicals that inhibit stones forming. In some people with kidney stones, these inhibitors seem not to work properly.

The ureteroscopic stone removal procedure consists in freeing the ureter (using a mini-invasive rigid device), or the kidney (using a flexible device) from the stones by breaking them in pieces and removing if possible the fragments. The surgeon inserts an endoscope into the bladder through the urethra. Under X-ray screening, a flexible guide wire is inserted into the affected ureter between the kidney and the bladder, it will guide the endoscope into the ureter.

A longer endoscope (either rigid or flexible) is then inserted into the ureter and may be passed up to the kidney if necessary. The stone is disintegrated using ballistic probe or laser fragmentation and the majority of fragments extracted with special retrieval devices

At the end of the procedure a soft plastic tube or stent (JJ stent) may be set up between the kidney and the bladder to avoid renal colic induced.

The Ureteroscopic treatment allows breaking down urinary stones into small fragments and getting rid of them during the procedure for immediate relief.

This treatment is used when less invasive treatments can not be used or have not proved to be efficient; indeed sometimes the stone is too large to break up with ESWL, or not suitable for ESWL, and endoscopic surgery is then required.

 

About the medical devices and the surgical technique used

For ureteral stones is used a mini-invasive rigid ureteroscope with a guide wire, a ballistic probe or a laser Holmium fibre for stone fragmentation, and a basketorgraspingforcepsdevice forstoneextraction. For kidney stones it is used a flexible ureteroscope with a ureteral introducer, two guide wires, a laser fibre, and a basket catheter for stone extraction.

The procedure is screened both by X-rays and a video camera.

A ureteral stent may be set up at the time of surgery. Its goal is to facilitate the urine flow from the kidney to the bladder, and to avoid renal colic. It will also dilate the ureter and then permit stone’s fragments migration after removal. The JJ stent removal is usually done under local anaesthesia between 1 and 4 weeks later.

Implants used all come from suppliers that are: o Renowned worldwide, o Accredited by European medical device standards, o Selected for their quality and longstanding reputation.

When checking out of the hospital, a document bearing the prosthesis’ serial number will be given to you to enable long-term follow up in the best possible conditions.

And then?

During the following days, you should drink between 1,5 and 2 litters /day to flush your urinary system and minimise any bleeding. You may experience pain in the kidney over the first 24-72 hours, due to the insertion of the instrument or by the presence of a stent. In case of stent it is better to avoid walking too much. If need be, anti-inflammatory painkillers will help this pain which normally settles after 72 hours but will be continue if necessary.

It will take at least 10 days to recover fully from the operation. You should not expect to return to work within 7 days.

You can prevent further stone recurrence by implementing changes to your diet and fluid intake. Blood, urine analysis and spectrophotometry analysis of stones’ fragments will help to find the best diet for you.
expand_less