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Ureteroscopy is an examination of the upper urinary tract, usually performed with a ureteroscope that is passed through the urethra and the bladder, and then directly into the ureter. [1] The procedure is useful in the diagnosis and treatment of disorders such as kidney stones and urothelial carcinoma of the upper urinary tract. [ 1 ]
The procedure is usually done under general or regional anesthesia. [13] Risks of complications of the procedure includes: pyelosinus extravasation (contrast going into renal sinus) and pyelotubular (contrast going into collecting duct) reflux of contrast due to overfilling of the urinary system. It can cause pain, fever and chills.
The procedure is more painful for men than for women due to the length and narrow diameter of the male urethra, and results of a 2019 systematic review of the literature found that intraurethral lidocaine greatly reduces this painful procedure in men. [5] Relaxing the pelvic muscles helps make this part of the test easier.
The stent is removed by cystoscopy, an outpatient procedure. Cystoscopy involves placement of a small flexible tube through the urethra (the hole where urine exits the body). The procedure, which usually takes only a few minutes and causes little discomfort, is performed in an outpatient clinic or ambulatory surgery centre.
Bilateral ureterostomy: This procedure brings the two ureters to the surface of the abdomen, one on each side. Double-barrel ureterostomy: In this approach, both ureters are brought to the same side of the abdominal surface. Transuretero-ureterostomy (TUU): This procedure brings both ureters to the same side of the abdomen, through the same stoma.
Children may have painful micturition after the procedure, which can lead to urinary retention (children afraid to pee due to pain). Some painkillers or peeing inside a warm bath may help. Those children who receive antibiotics before the procedure for urinary tract infection will double the dose for 3 days after the procedure.
Research is currently uncertain if placing a temporary stent during ureteroscopy leads to different outcomes than not placing a stent in terms of number of hospital visits for post operative problems, short or long term pain, need for narcotic pain medication, risk of UTI, need for a repeat procedure or narrowing of the ureter from scarring. [117]
A retrograde urethrography [1] is a routine radiologic procedure (most typically in males) used to image the integrity of the urethra. Hence a retrograde urethrogram is essential for diagnosis of urethral injury, or urethral stricture. [2] [3]