Laser Semi-Rigid Ureteroscopy
This procedure is suggested in the following cases:
We begin by introducing a “Sensor”-type metallic telescope to get our bearings and for security purposes. The instrument used is a rigid ureteroscope that is introduced via natural passageways till it reaches the stone. Generally, the stone is fragmented by fibre laser or caught using a “retrieval basket” probe (Zero Tip® in nitinol).
The higher the stone, the more difficult its progress. The procedure sometimes requires a flexible ureteroscope or a second intervention, administered after having prepared the ureter by installing a double J stent to help progressive dilation.
The intervention takes place under general or spinal anesthetic. It is performed in one day without hospitalisation. The movement is executed by direct vision using a camera and under fluoroscopic monitoring. Today, it is rarely necessary to dilate the ureter to ease the penetration of the instrument. When the stone is removed or fragmented, it becomes necessary to leave a double J stent in place in the ureter to reduce post-operative pain. This is also helps facilitate the elimination of eventual stone debris.
Resuming work and physical effort is permitted very shortly after the intervention. The double J stent leads to a certain amount of discomfort: bleeding in the urine (variable depending on activities), burning while urinating, frequent urination or back pain while urinating (which can be avoided by urinating frequently and sitting down bending forward). The double J stent is then removed under local anesthetic by cystoscopy.