A Detailed Guide to Ureteric Stone Surgery

 The ureters are the tubes that carry urine from the kidney to the bladder. A stone in the ureter is a mass of minerals that may have come from the kidney and moved down into the ureter. The formation of a stone starts when mineral fragments in standing urine crystallize and solidify into a mass. A stone that is small enough may disengage, slip through the ureter, and exit the body undetected. If it is too big, it could get stuck in the ureter and stop the urine from flowing.

This blog will delve into a detailed guide for ureter stones, including their causes, symptoms, ideal candidates, and treatment details. To make this post authentic, we have gathered insights from Dr. Niren Rao, a renowned urologist for ureteric stone surgery in Delhi. Identifying the right causes and symptoms is mandatory to provide effective treatments. It is also important to know whether one would be an ideal candidate for the treatment. Let’s start by learning the causes of ureter stones.

Causes of Ureter Stones

Although the exact causes of ureter stones are unknown, those with a family history are more susceptible. Urinary tract infections, cystic kidney diseases, and some metabolic disorders are also linked to the development of stones. Urine stones may also occur in people with chronic bowel inflammation. The condition may also develop due to ostomy surgery or intestinal bypass surgery, which creates surgical openings in the body to discharge waste. Under such circumstances, limiting foods high in oxalate, such as chocolate, peanuts, soybean crackers, beets, spinach, rhubarb, okra, or black Indian tea, may be advised. Instead, one can consume red raspberries, strawberries, marmalade, liver, celery, grapes, and grits.

Symptoms of Ureter Stones

A small ureter stone will not show any symptoms. If it grows to the point where it becomes an obstruction, it will stop the urine's flow and cause excruciating pain. It will also cause cramps in the lower abdomen and kidney region, which may eventually spread to the groin. When the body tries to pass the stone, the urine may become more painful and burn while urinating. It may also turn pink from the blood.

Introduction to Ureteroscopy

Ureteroscopy is an outpatient procedure that is most commonly used to treat kidney or ureteral stones. Additionally, it can be applied to treat and assess other causes of kidney blockage or blood in the urine. Ureteroscopy is performed using a ureteroscope, which is a long, thin tube with an eyepiece on one end and a tiny lens and light on the other. Ureteroscopy for stones is generally performed in two ways:

• If the stone is small, the medical professional will use a scope to extract it from the ureter. The particular scope utilized in this process will have a tiny basket attached to the end of a wire that passes through an additional ureteroscope channel. Stones are collected using the basket.

• If the stone is bigger, the medical professional will put a flexible fiber through the scope and up to the stone. The medical professional will use a laser beam passing through the scope to break the stone into pieces small enough to be expelled from the body through urine.

The doctor will decide which ureteroscopy treatment option is best for a person based on the location, size, and type of stone.

Ideal Candidates for Ureteroscopy

A ureteroscopic procedure is required to remove stones from a patient. Surgery is not always necessary to remove ureteral stones; some can be removed with medication and enough water intake. Surgery is required in the following situations:

• The stone is larger than 8 mm in size
• Long-term medical therapy has not assisted in the removal of stones
• Hematephrosis, a condition brought on by stones, can eventually result in renal failure
• Many oral and injectable analgesics are necessary to relieve the severe pain caused by a badly impacted stone
• An infection and pus formation caused by a ureteric stone have resulted in a high-grade fever and flank pain
• Urine bleeding frequently occurs due to a ureteric stone (haematuria).

Preparation for a Ureteroscopy Surgery

The decision to perform ureteric stone surgery is made after a careful assessment of the patient's condition. Every patient with a ureteric stone should ideally have a non-contact CT scan (NCCT KUB). This indicates the precise location, size, and extent of the kidney swelling and stone.

• Prior to surgery, a urine culture should be performed to rule out infection. It is recommended to begin antibiotics three to four days before surgery in case of infection.
• CBC test to determine whether the patient is surgically fit.
• Pre-operative examination for anesthesia.
• Evaluating the patient's blood pressure and sugar control to see if they have hypertension or diabetes.
• Putting an end to blood-thinning medications like clopidogrel and aspirin at least one week before surgery.
• Patients are advised to fast on the day of surgery.

The Ureteroscopy Procedure

• This procedure can be done under both spinal and general anesthesia
• Patients are positioned in lithotomy positions, with their legs raised in the air.
• A ureter scope, which is a long, thin telescope, is inserted into the bladder through the urethra, the passageway used for peeing. Following that, the ureteroscope is carefully placed into the ureter while guided by radiography.
• After visualization, the stone is divided into smaller pieces and extracted using specialized forceps.
• After the surgery, a hollow tube known as a double J or DJ stent is inserted into the kidney from the bladder.
• The stent helps lessen the risk of tiny stone fragments obstructing the ureter and producing pain and kidney swelling (hydronephrosis).

According to Dr. Niren Rao, a renowned urologist, the ureteric surgery cost in Delhi ranges from Rs. 30,000 to Rs. 50,000. This depend on factors like patient’s condition, stone size, and more.

Expectations After Ureteroscopy Surgery

In order to prevent infection, the surgeon might prescribe an antibiotic for the first two days following the procedure. Fever, chills, and worsening pain are indicators of an infection. If one observes any of those symptoms, they should inform their healthcare provider.

• The majority of ureteroscopy patients have mild to moderate pain, which is treatable with medicine.
• To stop infections, injections of antibiotics are administered.
• Patients are discharged from the hospital 24 hours following the removal of the catheter.
• Patients may notice pinkish urine for the first few days, but this goes away over time.
• A slight burning sensation and increased micturition frequency and urgency are possible.
• Because of the stent, patients may feel some slight back pain after passing pee.

Conclusion

Any type of stone can cause major problems if not treated immediately. Urinary stones can form when the body doesn't produce enough urine to remove the waste product. Fortunately, ureteroscopy stone surgery can help remove these kinds of stones. It is an entirely painless, cutless, and safe procedure.

Searching for a urology hospital in Delhi? Visit a leading urology hospital, Delhi Urology Hospital, for the best results from the surgery. The hospital’s founder, Dr. Niren Rao, is a highly qualified urologist who has been successfully operating on stones for his patients. To learn more, pay a visit to Delhi Urology Hospital.

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