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Ureteroscopy and Lithoclast

Ureteroscopy and Lithoclast procedure

Ureteroscopy and lithoclast involves passing a small telescope, called a ureteroscope, into the inside of the urinary tract via the urethra and bladder, and will require a general anaesthetic. The scope is passed up the ureter to determine where the stone is located. Depending on the size of the stone, if small enough, it may be removed whole with a basket device. If the stone is too large it may require laser treatment to fragment it into smaller pieces. This procedure is called Pyelopscopy and Lasertripsy.

The pre and post procedure information and instructions for Ureteroscopy and Lithoclast are the same for Pyeloscopy and  Lasertripsy, and are below.

Pyeloscopy and Lasertripsy procedure

Flexible Pyeloscopy and Lasertripsy is a procedure where a fibre optic telescope is introduced into the kidney via the urethra into the bladder and up to the ureter. The stone is then fragmented into sand like consistency to allow easy passage. This procedure does not involve any surgical incisions and is performed under a general anaesthetic.

Preparation for your procedure

Investigations

It is important you complete any investigations requested in the time indicated to avoid cancellation of your procedure.

  • You will be required to provide a urine test 10-14 days prior to your procedure
  • You will be advised if there are any other investigations that are required before your procedure e.g. Scans, bloods or ECG

Medications

  • Please cease fish oils or other health supplements seven days prior to surgery
  • Please cease aspirin seven days prior to surgery if not prescribed by a doctor
  • You may be required to cease prescribed medications prior to your procedure. You will receive instructions for this when your date has been allocated. It is important that you never cease any medications without discussing first with your doctor.  
  • You can continue taking anti-inflammatory medication

On the day of the Procedure 

  • It is important when having a general anaesthetic that you fast for six hours prior to your operation—i.e. have nothing to eat or drink. This includes lozenges, lollies and gum.
  • Please ensure that PRIOR to fasting you do consume food and water to avoid dehydration
  • Do not smoke cigarettes or tobacco products the morning of your procedure
  • Shower at home and do not apply powder, deodorant, creams or ointments
  • You are required to present to the Day Procedure Unit, Level 5 of Mater Hospital Brisbane for admission at the allocated time

What to expect after the procedure

  • You may require admission overnight after your procedure for observation
  • You may wake up with a catheter draining your bladder. If you do wake up with a catheter, it will be removed prior to discharge
  • Sometimes you will have a temporary tube in your ureter (ureteric stent) which allows for the urine to pass from your kidney to your bladder without blockage. This may be attached to the catheter and removed prior to discharge, however if the stent is not attached to the catheter you will be requested to return for stent removal in 2-4 weeks. An information sheet is available - Ureteric stent information sheet
  • You may have pain, some blood in urine as well as urgency and frequency with urination. These symptoms should resolve within a few days following surgery. (Symptoms may continue longer if you are discharged with a stent).

After discharge from hospital

  • You may have some pain which should be relieved by simple analgesia
  • Your Urologist may provide you with  a script for antibiotics to take in the days following surgery and it is important you complete the course as prescribed
  • It is Important to maintain hydration. Unless contradicted we would recommended  2.5L of fluid per day
  • If you were advised to change your anticoagulant medication prior to surgery it is important that you understand when to recommence 
  • You should not drive a car, motorcycle or ride a bicycle for 24hrs after surgery as you have had a general anaesthetic. This is a legal requirement.
  • You can normally return to work within 1-5 days. This will depend on your occupation and how you are recovering in terms of pain etc.

Follow-up 

  • This varies but will normally involve repeat imaging and symptom review via outpatient appointment or phone call from a Urology nurse
  • If you have a ureteric stent inserted, an appointment will be made for removal and it is vital this is completed as ureteric stents are only temporary and cannot stay in permanently

Risks or possible complications

Your Urologist will discuss these with you at the time of signing your consent form.

Complications may include:

  • Infection
  • Stone pieces causing blockage of urine flow. This may require further procedures
  • Damage to other organs with heavy bleeding and/or blood clots in your urine
  • Failure to break stone adequately. This may require further procedures

If you have the following you should seek medical attention

  • Fevers or chills
  • Severe and ongoing abdominal pain or kidney pain
  • Heavy bleeding or clots
  • Signs of urinary tract infection e.g. offensive smelling urine, cloudy urine, worsening pain on urination

If you have any changes or concerns before your follow up you should contact your GP or the Mater Hospital Brisbane Department of Urology on 07 3163 3490, Monday to Friday 7.30 am

Mater acknowledges consumer consultation in the development of this patient information.
Mater Doc Num: PI-CLN-420053
Last modified 10/4/2018.
Consumers were consulted in the development of this patient information.
Last consumer engagement date: 31/7/2015
For further translated health information, you can visit healthtranslations.vic.gov.au/ supported by the Victorian Department of Health and Human Services that offers a range of patient information in multiple languages.
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