Urinary stones are stones that form in any part of the urinary tract including the kidneys, ureters, or bladder. Kidney stones are one of the most painful urological disorders. With the advent of minimally invasive surgical treatments for kidney stones, open surgery is now rarely required. Most cases of kidney stones can be managed with no-scalpel surgery.
Laser stone surgery using a flexible pyeloscope is a minimally invasive procedure used to treat kidney stones without the need for an incision. In this procedure, the urethra is used as an entry point for the flexible ureteroscope (pyeloscope). The procedure has a high success rate and can be performed as day surgery. Moreover, it is relatively safe and has only a small risk of infection, mild bleeding or damage to the ureter. It is used to treat kidney stones up to 2cm in size.
The procedure is performed under general anaesthesia and usually takes about 60 to 90 minutes. It involves inserting a flexible scope (pyeloscope) less than 3mm in diameter into the kidney from the bladder via the urethra. The flexible nature of the scope allows visualization of the entire kidney drainage system and helps to locate the stone. The pyeloscope also has a small instrument port through which a laser fibre (0.3 mm diameter) is introduced. Once the stone is located within the kidney, the laser is used to fragment the kidney stone. Micro baskets (less than 1 mm wide) are then used to remove the fragmented stones. Sometimes, a temporary urinary stent is left in place for a short period to ensure that stone fragments are drained from the kidney and ureter without the risk of blockage.
After the procedure
If urinary stent is left in place, care should be taken so as not to accidently dislodge the stent. After the procedure patients often feel the need to urinate and some people may notice blood in their urine. Oral antibiotics and simple analgesics are usually prescribed to prevent infection and reduce pain. Occasionally, a stronger analgesic may be required. As general anaesthesia is used for the procedure, driving should be avoided for at least 24 hours after the procedure.