Ureteroscopy

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The ureteroscopy (ureteroscopy) is a urological examination of the ureter .

technology

Rigid, semi-rigid and flexible endoscopes are available for ureteroscopy. They have a diameter of 2.0 to 4.0 mm and a light guide with optics, a working channel and a rinsing channel. For technical reasons, particularly semi-rigid mini- ureteroscopes have proven themselves .

scope of application

The most common application is the removal of urinary stones or stone rubble after extracorporeal shock wave lithotripsy (ESWL). In addition, ureteroscopy is used for ureter constrictions and as a diagnosis of exclusion in ureter and renal pelvis tumors.

requirements

Before the examination, the anatomical conditions of the urinary tract are examined with the help of sonography (ultrasound) and X-rays (native image, excretory urography ) in order to present the findings. In addition, it is necessary to record the parameters of blood coagulation (e.g. Quick value and partial thromboplastin time ), a small blood count and a urine test including urine culture .

Contraindications

Absolute contraindications are coagulation disorders and urinary tract infections . A relative contraindication is pregnancy. Technical contraindications can be ureteral stenoses and strictures .

Procedure of the investigation

Depending on the problem, the ureteroscope is pushed through the urethra and from there into the ureter. If the urethra is not open (e.g. because of an enlarged prostate ), the urinary bladder is punctured through the abdominal wall, thus creating access to the urinary bladder and ureter. At the end of the examination, a ureteral stent (sunk stent ) is inserted which, if no complications occur, can be removed after 48 hours. The examination usually takes place under general anesthesia or spinal anesthesia instead.

Complications

Possible side effects and complications with corresponding frequency:

  • Perforation of the ureter (approx. 8-17%)
  • Fever (approx. 5%)
  • Development of a stenosis requiring therapy (approx. 1–5%)
  • Ureter rupture (approx. 0.5%)

See also

Web links