Risks and Complications of Ureteroscopy
Ureteroscopy is relatively a complication free procedure. However if complications do occur they may be related to the anesthesia or the procedure itself.
1. Anesthesia complications
Spinal anesthesia - Headaches, low blood pressure, infections, like meningitis. However these are rare and unusual complications.
General anesthesia - Reaction to drug, nausea and vomiting, drowsiness, throat or chest infections.
2. Procedure complications
Difficulty in entering the ureter – Occasionally, due to swelling or the course of the ureter, it maybe difficult to enter the ureter. In such a case usually a stent is left and the procedure is tried after a week or two.
Stone migration into the kidney - A small stone may run up into the kidney. In such an event ESWL is required to break the stone.
Small mucosal tear of the wall of the ureter- This is usually a minor problem.
Small perforation of the wall of the ureter – This may occur when the stone is either sharp or stuck in one location. In most situations a temporary stent can tide over the problem. A major perforation may require an open surgical re-implant of the ureter.
Avulsion of the ureter – this is a major complication and requires a replacement of the ureter with part of intestine. An open operation is required.
Stricture of the ureter – In long- term follow up, some patients may develop a narrowing of the ureter. This maybe related to the stone or due to the use of the ureteroscope or due to thermal injury caused by a laser probe.
After ureteroscopy observation of the patient is done in the recovery room and the ward.Once the surgery is over, you will be shifted to the recovery area where you will come out of the anaesthesia and your temperature will be checked. Once you are stable, you will be shifted to the ward. Do not get alarmed by seeing blood in your urine-collecting bag after the surgery. As you keep taking water, during the course of the day, it will become normal. Usually, you can have light drink and small amount of food 3 to 4 hours after the surgery.
If a stent has been placed in your system, a check X- ray will be done to see if it is in proper position.
The catheter will be removed on the first or second post operative day and you will be treated with anti-biotics and pain killers after the surgery for a few days.
If all goes well and you are comfortable, you can be discharged on the same day or the second or third day following the surgery. You will be asked to come for review after a week or two, to observe your progress after surgery. A decision about stent removal will be made at that time. You will also be given medicines which prevent further stone formation.
Good hydration means plenty of water and other fluids and this can prevent further kidney stone formation.
1. A good first step for prevention is to drink more liquids — water is the best. If you tend to form stones, you should try to drink enough liquids throughout the day to produce at least two liters of urine in every 24-hour period.
2. People who form calcium stones are usually told to avoid dairy products and other foods with high calcium content. However, recent studies have shown that foods high in calcium, including dairy foods, help prevent calcium stones.
3. If you are at risk for developing stones, your doctor may perform certain blood and urine tests to determine which factors can best be altered to reduce the risk. Some people will need medicines to prevent stones from forming.