Ureteroscopy (Stone Extraction)
Introduction
Ureteroscopy is the medical term referring to the process of stone removal from the ureter. It is the tube that conveys urine from the kidney down to the bladder. This treatment is usually suggested to patients suffering from kidney stones who are unable to pass it normally through the ureter. Ureteroscopy is an interventional process that results in a relatively quick recovery period with effective results.
What is Ureteroscopy?
The scope used for the procedure is ureteroscopy, a form of diagnosis and treatment in which a very narrow, flexible tube called a ureteroscope passes through the urethra to reach into the bladder, hence into the ureter, to reach the location of the stone. A viewfinder will assist the surgeon to see where the stone is; using specialized equipment, it is possible to then remove it from the ureter. A laser can sometimes break the stone up into pieces for easier removal.
Why is Ureteroscopy Needed?
Ureteroscopy is usually applied for cases where there are large stones in the kidneys that cannot pass through on their own or stones whose obstructions cause severe pain and lead to infection. A blocked stone in the ureter may cause much pain and damage to the urinary system. Ureteroscopy aids in relieving this through the destruction or fragmenting into tiny pieces of the stones to prevent complications like the development of kidney damage.
Types of Ureteroscopy
There are two major types of ureteroscopy:
- Rigid: This involves using a straight, rigid scope in cases where the stones are near the bladder.
- Flexible: This is a more commonly used approach, where a bendable scope navigates through the ureter and into the kidney.
The type of Ureteroscope procedure performed depends on the location, size, and type of stone.
Procedure Steps of Ureteroscopy
- Preparation: The medical staff asks the patient to fast for a few hours before the procedure. The doctor administers a local anesthetic or general anesthesia.
- Insertion of Ureteroscope: The doctor gently inserts the ureteroscope through the urethra, into the bladder, and then into the ureter.
- Stone Removal: Using special tools or a laser, the team either removes the stone or breaks it into smaller pieces.
- Post-Procedure Care: After the procedure, the doctor may place a stent temporarily in the ureter to allow for proper drainage and healing. The medical staff usually removes it after a few days or weeks.
Benefits of Ureteroscopy
- Minimally Invasive: Ureteroscopy is less invasive compared to traditional surgery, which only requires small incisions.
- Quick Recovery: Most patients experience faster recovery compared to open surgeries.
- Effective: It provides a high success rate in removing stones and preventing complications.
- No Injections Required: Unlike other surgeries, the Ureteroscope procedure does not require major cuts, hence a lower chance of infections and scarring.
Cost of Ureteroscopy
| Country | Cost Range (USD) |
| India | $2,000 – $4,000 |
| USA | $8,000 – $15,000 |
| UK | $6,000 – $10,000 |
India is still the cheapest destination for ureteroscopy with excellent care, significantly cheaper than the Western countries.
Top Hospitals in India for Ureteroscopy
There are many hospitals in India where ureteroscopy is performed. Some of the top hospitals in stone removal are:
- Metro Hospital, Faridabad
- Fortis Escorts Heart Institute, Delhi
- Max Super Specialty Hospital, Delhi
- Medanta: The Medicity, Gurgaon
Advanced technology and medical expertise at these hospitals ensure high success rates and patient satisfaction.
Risks and Complications
Ureteroscopy is a relatively safe procedure, but as with all other medical interventions, there may be some potential risks and complications:
- Infection: Infection is as prevalent in any surgical intervention.
- Bleeding: Bleeding may be minor but might be acute if it occurs seldom.
- Injury to Ureter: The procedure might unwittingly damage the ureter or bladder.
- Stent Discomfort: A stent may irritate and may require withdrawal after a few days.
It is pertinent to follow post-procedure care to minimize these.
Recovery from Ureteroscopy
The recovery period after ureteroscopy is usually short. Most patients can go home the same day or after a short hospital stay. The stent, if placed, will be removed after a few days to weeks. Mild discomfort, such as a burning sensation during urination or the need to urinate more frequently, is common and usually resolves within a few days.
Patients should drink plenty of fluids to help flush out any remaining stone fragments and avoid strenuous activities for a few weeks to allow the body to heal properly.
