A “ureteroscopy” is a procedure to directly visualise the ureter (the tube that drains urine between the kidney and the bladder) using a very fine camera. A “pyeloscopy” is the visualisation of the collecting system of the kidney (where urine collects inside the kidney before it drains via the ureter into the bladder). Often these procedures are performed in order to treat an abnormality, such a kidney stone. Sometimes they are done to investigate abnormalities seen on a scan (eg. tumour). Often, a ureteric stent is placed or replaced during one of these procedures as a safety precaution, in order to prevent complications after these procedures.
The procedure is performed under a general anaesthetic. A cystoscopy, (examination of the inside of the bladder and the urethra), is performed first with a special viewing camera. Dye is then injected into the ureter and x-rays are taken to outline the urinary collecting system from the kidney to the bladder. A guide wire is then placed up to the kidney for safety and a flexible or rigid ureteroscope is then able to be used to reach the area of interest in the ureter or kidney. Special tools such as a laser or basket can be passed through instruments to blast or extract stones for example. After the procedure is complete, a ureteric stent is usually inserted under x-ray guidance.
WHAT CAN I EXPECT AFTER THE PROCEDURE?
- Burning when passing urine for 1-2 days
- Pain at the end of your void (stent scratching bladder or urine refluxing to kidney), which can be felt in the flank, groin or genitals
- Voiding frequency, urgency and incomplete emptying
- Some blood in the urine
- For some patients these “stent irritation” symptoms can persist and temporarily worsen until the stent is removed
WHAT ABOUT DIET?
- Drink plenty of fluids (8-10 glasses or 2-3 litres)
- Eat a diet high in fibre to prevent the need for straining when using your bowels
WHAT ABOUT EXERCISE/ACTIVITY?
- Avoid strenuous activity, heavy lifting or engage in sports for the next day unless otherwise instructed by your doctor
- Avoid driving a car, motorcycle or ride a bike for 24 hours after your procedure and do not walk home or travel alone by public transport
- Some activities such as exercise and bending can exacerbate stent irritation symptoms, but there are no absolute restrictions
WHAT ABOUT MEDICATIONS?
- You can resume your usual medications
- If your blood thinning medication was stopped, your Doctor will let you know when to recommence
- You can take 1-2 paracetamol every 4-6 hours for pain and discomfort (no more than 8 in a day)
- Ural sachets (urine alkaliser) available from chemists and supermarkets, reduce acidity of the urine and provide relief from symptoms such as burning and stinging
WHAT ARE THE POSSIBLE COMPLICATIONS?
- Significant bleeding, possibly with clots
- Urinary infection (can be severe in 3% of cases)
- Urinary retention (unable to pass urine)
- Ureteric injury – this is very rare and is usually treated with leaving the stent in for a few weeks to allow the ureter to heal
NOTIFY GM UROLOGY or your GP if you experience any of the following:
- Fever (temperature over 37.5 degrees), chills, shakes or feeling generally unwell
- Increased discomfort, severe pain and burning when passing urine
- Cloudy or offensive urine
- Heavy bleeding – urine that looks like pure blood
- Increasing difficulty or unable to pass urine
FOLLOW UP APPOINTMENT
Your doctor will generally speak to about the results of the procedure before you are discharged home and an appointment for your follow-up procedure or removal of the stent will be organised (roughly within 2 weeks). If an appointment time is not given to you on discharge from hospital, you will need to phone GM Urology to make an appointment.
If you have any queries please contact GM Urology on 03 5201 7000 during business hours OR leave a message on the After Hours Urology Paging Service 03 9387 1000