Ureteroscopic Lithotripsy in Delhi

Indications

Ureteroscopic lithotripsy is indicated in the following situations:

• Stones in the Ureter or Kidney: Stones that are causing pain, infection, or blockage.
• Failure of Other Treatments: Stones that have not been successfully treated with other methods such as extracorporeal shock wave lithotripsy (ESWL) or medication.
• Large Stones: Stones that are too large to pass on their own or are causing significant symptoms.
• Stone Location: Stones located in areas of the urinary tract that are difficult to reach with other non-invasive treatments.

Procedure Steps

1. Preoperative Preparation
   • Evaluation: Comprehensive medical evaluation, including imaging studies like CT scans or X-rays to determine the size, location, and type of stone.
   • Medical History: Assessment of the patient’s overall health, allergies, and any previous reactions to anesthesia.
   • Patient Education: Explanation of the procedure, risks, benefits, and expected outcomes.
2. Anesthesia
   • General or spinal anesthesia is typically administered to ensure the patient is comfortable and pain-free during the procedure.
3. Surgical Procedure
   • Insertion of Ureteroscope: A ureteroscope, which is a thin, flexible tube with a camera and light, is inserted through the urethra and bladder into the ureter to visualize the stone.
   • Identification of the Stone: The stone is located using the ureteroscope.
   • Stone Fragmentation: Once the stone is identified, it is broken into smaller pieces using laser lithotripsy (a laser is directed at the stone to break it up) or other devices like pneumatic or ultrasonic lithotripsy.
   • Removal of Fragments: The stone fragments may be removed using a basket-like device or allowed to pass naturally through the urinary tract.
   • Stent Placement (if needed): A temporary stent may be placed in the ureter to keep it open and ensure urine flow during healing.
4. Postoperative Care
   • Recovery: Most patients can go home the same day or after an overnight stay. Instructions on managing pain, staying hydrated, and monitoring urine output are provided.
   • Pain Management: Pain relief medications are prescribed as needed to manage discomfort.
   • Activity Restrictions: Avoiding strenuous activities for a few days to allow proper healing.
   • Follow-Up: Regular follow-up appointments to monitor healing progress and assess for any remaining stone fragments or complications.

Risks and Complications

• Infection: Risk of infection in the urinary tract.
• Bleeding: Risk of bleeding during or after the procedure.
• Injury to Urinary Tract: Risk of injury to the ureter or other parts of the urinary tract.
• Stone Recurrence: Possibility of new stones forming in the future.
• Ureteral Stricture: Narrowing of the ureter due to scar tissue formation.
• Pain and Discomfort: Temporary pain and discomfort, especially if a stent is placed.

Recovery and Outlook

• Immediate Recovery: Most patients experience mild discomfort and may see some blood in the urine, which usually resolves within a few days. Staying well-hydrated helps flush out remaining stone fragments.
• Stent Removal: If a stent is placed, it is typically removed after a few days to weeks, depending on the patient’s condition and healing progress.
• Long-Term Outlook: Ureteroscopic lithotripsy is highly effective in treating stones in the ureter and kidney, with a high success rate and low recurrence of treated stones. Regular follow-up and lifestyle modifications (such as increased fluid intake and dietary changes) are important to prevent new stone formation.

Conclusion

Ureteroscopic lithotripsy is a safe and effective procedure for treating kidney and ureteral stones that are causing symptoms or complications. The minimally invasive nature of the procedure allows for quick recovery and minimal postoperative discomfort. Close communication with healthcare providers and adherence to postoperative care instructions are essential for optimal outcomes and prevention of future stone formation.