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Ureteroscopy Stone Manipulation
What is
Ureteroscopy Stone Manipulation?
Ureteroscopy involves the use of ureteroscopes,
small flexible or semi-rigid telescopes that can
be inserted up the urethra, through the bladder
and into the ureter without an incision. These
instruments allow the doctor to view a ureteral
stone directly. They also have small working
channels through which various devices can be
passed to remove or fragment the stone.
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Effects
of Ureteroscopy Stone Manipulation
Urologists use ureteroscopy to remove stones
that are stuck in the ureter and are closer to
the bladder than the kidney (in the lower third
of the ureter).
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Candidates for Ureteroscopy Stone Manipulation
If
you have a stone lodged in your ureter or have
an area that needs more study in your ureter,
your doctor may recommend a ureteroscopy.
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Your Consultation
If
your doctor suspects a stone but is unable to
make a diagnosis from a simple X-ray, he/she may
scan the urinary system with intravenous
pyelography (IVP). It is an imaging technique
that utilizes radiopaque injections of dye
followed, during excretion by the kidneys, by
abdominal X-rays. A kidney obstructed by a stone
will not be able to excrete the dye as quickly
and may also appear enlarged when compared to
the normal organ. Since this technique requires
preparation, it has been replaced in many
hospitals by an abdominal/pelvic CT scan, an
extremely accurate diagnostic tool that can
detect almost all types of ureteral stones
painlessly.
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The
Ureteroscopy Stone Manipulation Procedure
Through the ureteroscope, the doctor can see the
stone. The doctor can then move the stone,
either by removing it with a small basket at the
end of a wire inserted through an extra tube in
the ureteroscope or by extending a flexible
fiber that carries a laser beam to break the
stone into smaller pieces that can then pass out
of the body in your urine. How and what the
doctor will do is determined by the location,
size, and composition of the stone. The doctor
may leave a stent, a flexible tube that keeps
the ureter open for drainage after the
procedure.
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Recovery
The
majority of ureteroscopic procedures can be
performed as day surgery and most individuals
can return to work within one to two days
following the procedure.
Although stone recurrence rates differ with
individuals, in general you have a 50 percent
chance of redeveloping stones within the next
five years. So prevention is essential. Your
urologist may follow-up with several tests to
determine which factors - e.g., medication or
diet - should be changed to reduce your further
risk.
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Risks
The
risks of ureteroscopy include perforation or
stricture (scar tissue), especially if the stone
has been impacted or embedded within the wall of
the ureter for longer than two months.
Complications are more likely when the stone is
close to the kidney (upper third of the ureter)
and include:
·
Injury to the ureter.
·
Urinary tract infection.
·
Bleeding.
·
Abdominal
pain.
Frequently Asked Questions
Q:
What is a ureteroscope?
A:
The
ureteroscope is a special, very thin instrument
used to look directly at and visualize the
inside of the ureter. Some ureteroscopes are
flexible like a small, very long straw. Others
are more rigid and firm.
Q:
What is a ureteral stone?
A:
A ureteral stone is a kidney stone that has
moved down into the
ureter.
The stone begins as a tiny grain of undissolved
material located where urine collects in the
kidney. When the urine flows out of the kidney,
this grain of undissolved material is left
behind. The material deposited is usually a
mineral called calcium oxalate. Other less
common materials that may also form a kidney
stone are cystine, calcium phosphate, uric acid
and struvite. Over time, more undissolved
material is deposited and the stone becomes
larger. Most stones enter the ureter when they
are still small enough to move down into the
bladder. From there, they pass out of the body
with urination. Some stones, however, have grown
larger by the time they leave the kidney. They
may become lodged in a narrow part of the ureter,
causing pain and possibly blocking the flow of
urine. These stones may need to be treated.
Q:
What are the signs and symptoms of this
condition?
A:
Usually, the symptom of a kidney stone is
extreme pain. Having been described as being
worse than childbirth, the pain often begins
suddenly as the stone moves in the urinary
tract, causing irritation and blockage.
Typically, a person feels a sharp, cramping pain
in the back and in the side of the area of the
kidney or in the lower abdomen, which may spread
to the groin. Also, sometimes a person will have
blood in the urine, nausea and/or vomiting.
Q:
My stone has not passed, do I need surgery?
A:
In general, you are facing surgery if your
stones are large enough to obstruct urine flow,
if they are potentially harmful to your kidneys
or if they are causing symptoms for which
medication does not help.
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The following list of Urology procedures are
performed at Beverly Hills Medical Group -
please click the links to find out more:
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