What Is URSL (Ureteroscopic Lithotripsy) Surgery?

URSL, or Ureteroscopic Lithotripsy, is a minimally invasive surgical procedure used to locate and treat kidney stones in the ureter and kidneys. The procedure is also known as URSL or ureteroscopy with laser lithotripsy (ULL). It is required when the kidney stones are untreatable by medicines or other non-surgical options.

In this medical procedure, the doctor puts a thin, flexible tube called a ureteroscope through the urethra and bladder into the ureter. The ureteroscope has a camera and a light at its tip, which allows the doctor to see the stones inside the ureter. The doctor then uses a laser or another device to break the stones into tiny pieces, which can be flushed out with urine or removed with a basket-like tool.

Benefits Of URSL Surgery

Ureteroscopic lithotripsy (URSL) is a minimally invasive surgical procedure used to treat kidney or ureteral stones. This procedure involves the use of a ureteroscope, a thin tube with a light and camera, to access and visualise the stones in the urinary tract. Here are some benefits of URSL surgery:

1. Minimally Invasive: URSL is a minimally invasive procedure because it doesn’t require large incisions. Instead, the ureteroscope is usually inserted through the natural urinary passages, either through the urethra and bladder or, in some cases, directly through the kidney.
2. High Success Rate: URSL has a high success rate in treating kidney and ureteral stones. The surgeon can directly visualise the stones and use specialised tools to break them into smaller fragments, making it easier for the body to pass or for further removal.
3. Reduced Recovery Time: Because URSL is minimally invasive, patients often experience shorter recovery times than traditional open surgical procedures. Most patients can return to normal activities relatively quickly after the surgery.
4. Short Hospital Stay or Outpatient Procedure: In many cases, URSL is conducted as an outpatient medical procedure, meaning the patient can go home the same day. Even when a short hospital stay is required, it is usually less extensive than more invasive surgical options.
5. Less Pain and Discomfort: Compared to open surgery, URSL generally causes less postoperative pain and discomfort. This is because there are no large incisions, and the trauma to surrounding tissues is minimised.
6. Lower Risk of Infection: The risk of infection is lower with URSL compared to more invasive procedures. Since there are no large incisions, the potential for contamination is reduced.
7. Preservation of Kidney Function: URSL allows for removing kidney or ureteral stones without causing significant damage to surrounding tissues. This preservation of kidney function is crucial for overall urinary and renal health.
8. Customized Treatment: The ureteroscope used in URSL allows for direct visualisation of the stones, enabling the surgeon to tailor the treatment to the specific characteristics of the stones and the patient’s anatomy.

Despite its benefits, URSL may not be suitable for all cases, and the appropriateness of the procedure depends on factors such as the size and location of the stones and the patient’s overall health. Individuals must consult with their healthcare providers to determine the most suitable treatment option.

What To Expect Before, During & After URSL (Ureteroscopic Lithotripsy) Surgery?

Here’s what you can generally expect before, during, and after URSL surgery:

Before URSL Surgery:

1. Medical Evaluation:

• Your doctor will do a complete medical assessment, which may include blood tests, urine tests, & imaging studies like CT scans or X-rays to determine the size, location, & composition of the kidney stones.

1. Preoperative Instructions:

• You may receive specific instructions on fasting before the surgery.
• Tell your doctor about any medications you are currently taking, and they may advise you to stop or adjust certain medications.

1. Anesthesia Discussion:

• You’ll discuss the type of anaesthesia used during the procedure. URSL is often performed under general anaesthesia, but in some cases, regional anaesthesia may be used.

During URSL Surgery:

1. Preparation:

• You will be taken to the operating room and positioned appropriately for the procedure.

2. Anesthesia Administration:

• Anesthesia will be administered, ensuring you are comfortable and pain-free throughout the surgery.

3. Ureteroscope Insertion:

• A thin, flexible tube referred to as a ureteroscope is inserted through the urethra & bladder into the ureter.

4. Stone Identification:

• The surgeon will navigate the ureteroscope to locate the kidney stone. Once found, the stone may be fragmented using laser energy, ultrasound, or another energy source.

5. Stone Removal:

• The broken fragments of the stone are either left to pass naturally through urine or removed using a basket-like device.

After URSL Surgery:

1. Recovery Room:

• After the procedure, you will be taken to a recovery room to wake up from anaesthesia. Monitoring will continue to ensure your vital signs are stable.

2. Pain Management:

• You may experience some discomfort or pain after the surgery. Pain medications will be provided to manage any postoperative pain.

3. Observation:

• Depending on the hospital’s protocols and overall condition, you may be observed for a few hours or overnight.

4. Postoperative Instructions:

• You’ll receive specific instructions on activities, diet, and medications to aid your recovery. It’s essential to follow these instructions closely.

5. Follow-Up:

• You'll have a follow-up appointment to remove the stent a few days after the procedure. There may be additional appointments; your doctor will discuss this with you.

It’s important to note that individual experiences may vary, and your healthcare team will provide personalised information based on your specific case. Always communicate any concerns or unusual symptoms to your healthcare provider during recovery.

Types Of URSL Surgery

The specific type of URSL procedure may vary based on the characteristics of the stones and the patient’s anatomy. Here are some common types of URSL procedures:

1. Laser Lithotripsy: Laser lithotripsy is one of the most common techniques used in URSL. It involves utilising a laser to break down kidney or ureteral stones into smaller fragments, making them easier to pass.

2. Procedure: The laser fibre is introduced through the working channel of the ureteroscope. The laser energy is then aimed at the stone, causing it to fragment into smaller pieces. These smaller pieces can be naturally passed through the urinary tract.

3. Pneumatic Lithotripsy:

• Description: Pneumatic lithotripsy uses pneumatic energy (compressed air or gas) to break down stones.
• Procedure: A specialised probe is introduced through the working channel of the ureteroscope, and rapid bursts of compressed air or gas are used to fragment the stone.

3. Mechanical Lithotripsy:

• Description: Mechanical lithotripsy involves the use of mechanical devices, such as graspers or baskets, to physically break up and remove stones.
• Procedure: A specialised instrument is passed through the ureteroscope’s working channel, and the stone is either grasped or captured in a basket-like device. Once caught, the stone can be crushed or pulled out.

4. Combination Techniques:

• Description: In some cases, a combination of different lithotripsy techniques may be used to treat stones effectively.
• Procedure: The surgeon may employ laser, pneumatic, or other combined techniques to address specific stone characteristics.

5. Fragmentation and Basketing:

• Description: In cases where the stone is too large to be removed entirely in one piece, it may be fragmented into smaller pieces using laser or pneumatic energy. After fragmentation, the smaller stone fragments are then basketed and removed.

The choice of the specific URSL technique depends on factors like the size and composition of the stone, the location within the urinary tract, and the patient’s overall health. The urologist will assess these factors and choose the most appropriate technique or combination of procedures for each individual case.

URSL (Ureteroscopic Lithotripsy) Surgery Side Effects

URSL Surgery is a minimally invasive surgical procedure used to treat kidney and ureteral stones. While it is generally considered safe & effective, there can be potential side effects like any medical procedure. It’s important to note that the specific side effects can vary from person to person, and not everyone will experience the same symptoms. Common side effects and potential complications of URSL may include:

1. Pain or Discomfort: It is common to experience pain or discomfort after the procedure. This can often be managed with pain medications prescribed by your doctor.
2. Blood in Urine: It is normal to see blood in the urine for a short period after URSL. However, if the bleeding is excessive or persists, you must inform your healthcare provider.
3. Urinary Tract Infection (UTI): There is a risk of having a urinary tract infection after URSL. Symptoms may include increased frequency of urination, urgency, and discomfort. Antibiotics may be prescribed to handle the infection.
4. Ureteral Stricture:  In some cases, scarring or narrowing of the ureter may occur, leading to a condition called ureteral stricture. This can cause difficulty in the passage of urine and may require further treatment.
5. Perforation:  Although rare, there is a small risk of injury to the ureter or surrounding tissues during the procedure, leading to perforation. This can sometimes require additional interventions.
6. Residual Stone Fragments:  Not all stone fragments may be removed entirely during the procedure. Residual components may pass on their own or require additional treatments.
7. Fever:  In some cases, patients may experience a fever, a sign of infection. It’s essential to report any persistent fever to your healthcare provider.
8. Reaction to Anesthesia:  If the procedure is performed under general anaesthesia, there is a small risk of adverse reactions to the anaesthesia drugs.
9. Allergic Reactions:  While rare, some patients may experience allergic reactions to medications or materials used during the procedure. It’s important to discuss potential risks & side effects with your healthcare provider before undergoing any surgical procedure. They can provide personalised information based on your health history and case details. If you experience severe or persistent symptoms after URSL, it’s crucial to seek prompt medical attention.

Why choose Genesis Superspeciality Hospital for URSL (Ureteroscopic Lithotripsy) Surgery?

Genesis Superspeciality Hospital always prioritizes patient safety, comfort, and satisfaction throughout the treatment process. Dr. Raju R possess a remarkable history of achieving successful results and holds substantial expertise in URSL (Ureteroscopic Lithotripsy) Surgery. With exceptional surgical outcomes and competitive pricing, our facility offers prompt surgical scheduling, minimizing patient wait times.