Ureteroscopic Kidney Stone Removal in Delhi
Most stones upto the size of 5 mm frequently pass through the ureter on taking lots of fluids or by medication.
Sizes more than 6 mm however do get stuck in any part of ureter and can pose a problem of colicky pain and infection.
URS is known to be a day care procedure meaning you can really go back home in most of the case the same day, however in certain cases you might be kept admitted overnight due to Prolonged effect of anaesthesia. Minor episode of bleeding which is transient.
The procedure with its inhert simplicity and precise nature can remove stones in ureter in all the parts of ureter.
The three parts namely upper, mid and lower ureteric stones behave differently when fragmented with laser. The ureteroscope reaches the stone and pulverizes the stone to small particles below 3 mm.
This action is continuously monitored on the monitor and hence the urologist can control his actions accordingly. The procedure is human operated and therefore is dependent on the expertise of the urologists.
Its worthwhile to note that all urologists are not choosing all the laser techniques available the reason being
URS or ureteroscopy ideally is best suited for stones upto 17 mm in mid and lower ureter.
Higher up located stones that is in upper ureteric region either get pushed to inside of the renal region or the the fragmentation energy is not enough to completely convert the stone to sediments.
For the upper ureteric stones the technology is called RIRS.
In the hands of an experienced urologist the technique is a boon to avoid open surgery and remove the ureteric stone with almost nil complications.
This technology uses a ureterscopy tube which has a light source and a camera attached to its tip.
This is passed through the normal urinary passage and is used to reach upto the stone in ureter.
After coming in contact with the stone ,laser is passed to pulverise the hard stone into particle form and is taken out in smaller particle form.
This technology is used for stones in ureteric or urinary bladder region.
No cut is given anywhere as natural urinary passage is used.
For stones found in the three parts of ureter, ureteroscopy is the best option as it is does not involve any trauma or cut in the body.
Secondly the stone removal is a single step procedure unlike ESWL.
The whole procedure is done under a a camera guidance and hence the results are closely monitored and verified.
The most approachable is the lower most part of ureter and here the success rate is highest 95to 98%.
In rare cases when the ureteral passage is very narrow or is stenosed by a stricture or a fold, the procedure might have to be abandoned due to poor or difficult passage of ureteroscope.
It is therefore advised to have a clearance by IVP and be sure of the passage.
When the stone is big more than 22 mm to 30 mm, it might be a cumbersome process to get all the contents out in a short time. Other options should be planned in such cases.
When the stone is higher in the ureter, the chances of it being pushed back to kidney are high. In such a case flexible ureteroscopy with holmium is very effective.