Ureteroscopy

Ureteroscopy is a common urological procedure administered in patients having urinary tract and bladder related disorders. Ureteroscopy is recommended for patients having kidney stones. The movement of the renal stones is monitored by urologists. Ureteroscopy is a minimal invasive endoscopic procedure predominantly involving the urethra, upper urinary tract and the urinary bladder.

Ureteroscopy Procedure

A flexible or rigid form of telescope is passed through the urethra in order to view the affected region. The procedure is performed under general or spinal anesthesia. The telescopic examination of the ureter and associated organs reveals the exact location of the stone and also other disorders of the system. Other diagnostic tests such as X-rays, CT scan, EKG along with laboratory parameters like urinalysis and complete blood count also help in the effective determination of the underlying condition. This technique is usually followed by the other associated procedures such as lithotripsy in which laser beams are administered to the affected region to dissolve the calculi(stone) or to clear urinary tract strictures. The entire procedure may last from 30 minutes to three hours and patients are advised to stay in the hospital for a day.

The urologist uses the uterescope to remove small kidney stones while larger stones need to be broken up before removal. A kidney stone that has escaped from the kidney and got stuck in the ureter can be pushed back into the kidney. Here it has to be broken into smaller pieces to aid removal. A stent is usually left in place to allow the kidneys to pass the urine to the bladder. This is kept for a few days in case there is swelling and subsequent difficulty in draining the kidney of the urine.

Complications and risk factors

Hematuria happens because of the insertion of the ureteroscope. It usually subsides within 3 days. Antimicrobial therapy is given if hematuria is followed by an infection. Other possible complications are:

Stent associated pain
Perforations caused because of stents
Abdominal pain
Lower back pain
Urethral stricture or perforation

Cystoscopy

Cystoscopy is done to examine and diagnose disorders of the urinary bladder and urinary tract. In this procedure, the internal structure of the urinary bladder and the urinary tract can be examined by using the cystoscope. Cystoscopes are administered as both diagnostic and treatment tools. Cystoscopy is predominantly done for patients experiencing recurrent urinary tract or bladder infection, urinary incontinence, hematuria and pain because of obstruction in the urinary tract. The procedure is performed by a urologist by inserting a tube called cystoscope through the urethra to identify disorder.

Cystoscopy Procedure

The duration of the procedure depends upon the condition of the patient. The procedure usually lasts about 45 minutes and it is performed under local, spinal or general anesthesia. Pathological specimens of the urinary bladder can also be obtained by using cystoscopes. Patients are advised to abstain from taking food or water six hours prior to the procedure. In case of rigid cystoscopy, the inserted cystoscope is used to remove any kind of lesions present in the urinary tract or the bladder. In the flexible cystoscopy procedure, the internal lining of the urinary bladder and the urinary tract are examined for abnormalities.

With cystoscopy, small bladder stones or foreign objects can be removed; thereby eliminating surgical intervention. Cystoscopy is useful in examining enlarged prostate, kidney stones and urethral blockage. This procedure is used to place urethral catheters or stents.

Complications of Cystoscopy

The complications associated with the cystoscopy procedure are mostly due to a perforation in the urinary tract. These perforations are caused during the procedure and might lead to urinary tract infection and bleeding. In men epididymitis occurs if testicles are involved during the procedure. The other complications include difficulty in passing urine and abdominal pain. In order to avoid the onset of urinary tract infection after the procedure patients are advised to take fluids preferably water every hour.

Kidney biopsy

A kidney biopsy is often recommended for those who notice blood in the urine (hematuria), excess protein in the urine (proteinuria) or progressive kidney failure. Kidney biopsy might reveal the causes for improper functioning or rejection of a transplanted kidney. If urine tests, ultrasound or CT scan reveal possible kidney problems, kidney biopsy can aid in determining the cause.

A patient undergoing kidney biopsy is given sedation through IV. The biopsy needle is inserted through the skin with the aid of ultrasound. A small sample tissue is taken for examination. There is likely to be mild soreness in the muscle and some blood in the urine for the next 24 hours. Serious complications include puncture of a major blood vessel or bleeding into the kidney. Abnormal results of kidney biopsy show signs of scarring or inadequate blood flow or signs of disease such as renal cancer. Patients with blood clotting disorder are not advised to undergo this diagnostic test. Obesity, UTI, hypertension are some factors that can affect the accuracy of kidney biopsy results.