A ureteroscopy is an outpatient procedure performed with a thin, lighted tube with an attached lens called a ureteroscope.
Should you suddenly develop difficulty with urination or show symptoms of kidney stones or ureteral stones, a procedure known as a ureteroscopy may be performed to discover what’s going on and perform the necessary treatment.
Whether or not a ureteroscopy can be used beyond diagnostic purposes will depend on the nature of the problem, the location of the affected area, and the size of the obstruction in the urinary tract.
What is a Ureteroscopy?
During a ureteroscopy, the scope is typically inserted through the tube that takes urine out of the body (urethra) and the bladder. The scope is further extended to the ureter, which is a tube that links a kidney to the bladder. Usually it’s the lower two-third portion of the ureter that’s accessible when a ureteroscopy is performed.
Candidates for Ureteroscopy
The most common reason to perform a ureteroscopy is because of suspected crystallized substances (stones) in either the ureters or kidneys. The procedure may also be done to determine the cause of blocked urine going from one or both kidneys to the bladder. Another reason to use a ureteroscope if there is blood in urine and the reason isn’t clear. A ureteroscopy may also be recommended for the following reasons:
- Unusual cells were discovered in urine and there’s a need to determine to search for a possible reason
- Ureteral scarring has occurred
- A cancerous or non-cancerous growth has been detected in a ureter and there is a need to view it in greater detail and possibly remove it
How it’s Performed
After a local anesthetic is applied to make the procedure more comfortable, the ureteroscope is slowly inserted through the urethra. A sterile liquid is passed through the scope to fill and stretch the bladder. This is done to provide a better view of the wall of the bladder. If a ureteroscopy is done purely for diagnostic purposes, the procedure may only take a few minutes. However, if a biopsy (tissue sample) needs to be taken, the procedure could last a bit longer. If ureteral stones are discovered, a tiny wire basket is typically placed through the scope via the bladder into the lower part of the urethra.
A stent is sometimes inserted to keep the affected ureter open so the stones can be removed. With larger kidney or ureter stones, certain processes may be done to fragment or break up the stones so they can be collected with the basket and removed. Fragmentation may be done with electrical energy, a pulsed dry laser, or shock waves.
After a Ureteroscopy
Most patients are able to safely resume their normal activities soon after having a ureteroscopy. There may be some minor discomfort after the local anesthetic wears off. Otherwise, patients typically respond well to procedures performed with a ureteroscope. Risks that may include infection and bleeding are considered minimal.
Good candidates for a ureteroscopy are individuals with kidney or ureteral stones or urinary tract obstructions within this area. Obese patients or pregnant women with blood clotting disorders may also benefit from a ureteroscopy for diagnostic and/or treatment purposes.