Kidney stones, also known as renal calculi, are hard deposits made of minerals and salts that form inside the kidneys or urinary tract. While small stones may pass on their own, larger or obstructive stones often require surgical intervention. One of the most effective and minimally invasive procedures for managing these stones is Ureteroscopic Lithotripsy Surgery.
Ureteroscopic lithotripsy, also known as URS or ureteroscopy with laser lithotripsy, uses a thin scope (ureteroscope) to locate and break up stones in the ureter or kidney using laser energy. This procedure has gained popularity due to its high success rates, quick recovery time, and minimal complications.
Why Ureteroscopic Lithotripsy Surgery is Recommended
Ureteroscopic lithotripsy is often suggested when:
1. Stones Are Too Large to Pass Naturally
Kidney or ureteral stones larger than 5-6 mm usually don’t pass without medical intervention. Ureteroscopic surgery allows the surgeon to directly access and fragment the stone.
2. Non-Responsive to Medication
When medical expulsive therapy and pain management don’t work, surgical removal is the next viable option.
3. Stone Location
If stones are located in the ureter (especially the lower third), URS provides direct access and better success compared to other methods like shock wave lithotripsy.
4. Recurrent Urinary Tract Infections
Kidney stones can cause blockages, leading to infections. If UTIs recur due to stone obstruction, URS can effectively remove the source of the problem.
5. Failed Other Procedures
If previous attempts at removing stones (like ESWL or PCNL) have failed, ureteroscopic lithotripsy is often the backup treatment option.
How Ureteroscopic Lithotripsy Surgery Works
Preoperative Preparation
- Diagnosis: The procedure begins with imaging tests such as ultrasound, CT scan, or X-ray to locate and size the stones.
- Fasting: Patients are advised to fast for 6–8 hours before surgery.
- Anesthesia: This surgery is typically performed under general or spinal anesthesia.
The Procedure
- Insertion of the Ureteroscope: A thin, flexible or rigid tube (ureteroscope) is passed through the urethra and bladder into the ureter or kidney.
- Visualization: The surgeon locates the stone using a camera at the tip of the ureteroscope.
- Laser Lithotripsy: A Holmium laser or similar device is used to break the stone into tiny fragments.
- Stone Removal: Larger pieces may be removed with a basket device; smaller fragments can pass naturally.
- Stent Placement: A temporary stent may be placed to ensure urine flow and reduce swelling in the ureter.
Duration
The procedure usually takes 30 minutes to 1 hour, depending on the stone size and number.
Postoperative Recovery and Care
- Hospital Stay
- Most patients can go home the same day or after an overnight stay.
- Recovery Time
- Initial Recovery: Within 1-2 days, patients can resume light activities.
- Complete Recovery: Full recovery typically takes 1-2 weeks.
Post-Surgery Symptoms
Some patients may experience:
- Mild pain or burning during urination
- Blood in urine (hematuria)
- Urinary urgency or frequency
These symptoms usually resolve within a few days.
Stent Removal
If a stent is placed, it is usually removed within 5–14 days after surgery. This is done via a simple outpatient procedure.
Benefits of Ureteroscopic Lithotripsy Surgery
- Minimally Invasive: No incisions are required.
- Quick Recovery: Patients return to normal life faster.
- High Success Rate: Effective in completely clearing stones, especially in lower ureter.
- Outpatient Procedure: Often done as a day-care surgery.
Potential Risks and Complications
While URS is generally safe, some risks may include:
- Ureteral injury or perforation
- Bleeding
- Infection
- Need for repeat procedure if fragments remain
- Temporary discomfort due to stent
Following post-operative care instructions and medications can significantly reduce these risks.
Tips for Faster Recovery After Ureteroscopic Lithotripsy
- Stay Hydrated: Drink 8–10 glasses of water daily to help flush out fragments.
- Avoid Heavy Lifting: Refrain from strenuous activity for a few days.
- Take Medications: Complete your prescribed antibiotics and painkillers.
- Follow-Up: Attend all follow-up appointments for stent removal and imaging.
Who Should Avoid Ureteroscopic Lithotripsy?
Though suitable for most people, certain cases might not be ideal for this procedure:
- Pregnant women (depending on trimester)
- People with uncontrolled infections or bleeding disorders
- Patients with narrow ureters or severe ureteral stricture
Alternative treatments may be explored in such situations, such as percutaneous nephrolithotomy (PCNL) or open surgery.
Conclusion
Ureteroscopic lithotripsy surgery is a game-changer in the world of kidney stone treatments. With high success rates, low complication risks, and minimal downtime, it stands as one of the top choices for treating ureteral or kidney stones, especially when less invasive options fail. If you’re suffering from recurring stone pain, urinary blockages, or infections, consult a urologist to explore whether URS is the right solution for you.
With proper medical care and post-surgery follow-up, most patients experience full relief from symptoms and return to normal life quickly. Don’t let kidney stones disrupt your life — take proactive steps and explore safe and effective treatments like ureteroscopic lithotripsy.
