Laser Kidney Stone Treatment in Birmingham

Ureteroscopy and laser kidney stone treatment transcript

1. Introduction and natural route: How can a kidney or ureteric stone be treated without making a cut in the skin? Ureteroscopy reaches the stone through the natural urinary passage, using a fine telescope with a camera.
2. Anaesthesia and entry into the ureter: The procedure is usually performed under general anaesthesia. The ureteroscope passes through the urethra into the bladder. The surgeon identifies the ureteric opening, then guides the instrument into the ureter.
3. Optional contrast imaging: When required, contrast medium and live X-ray imaging, called fluoroscopy, outline the ureter and kidney collecting system. This helps confirm the anatomy and stone position.
4. Safety guidewire: A soft guidewire may be passed through the ureter towards the kidney, maintaining secure access and helping the surgeon introduce instruments in a controlled manner.
5. Selecting and advancing the ureteroscope: The equipment depends on the stone’s position and your anatomy. A rigid ureteroscope may treat stones in the lower ureter. A flexible scope can bend into the kidney. An access sheath may be used for controlled passage of the flexible scope.
6. Direct examination: The camera provides a direct view inside the ureter and kidney, allowing the stone and surrounding collecting system to be assessed before treatment.
7. Laser treatment: If the stone cannot be removed intact, a fine laser fibre is passed through the scope. Under direct vision, the laser breaks the stone into removable fragments or dust-like particles.
8. Basket removal, inspection and withdrawal: Suitable fragments are removed with a fine basket and sent for analysis. Tiny particles may pass naturally. The collecting system is inspected before the instruments and ureteroscope are withdrawn under direct vision.
9. Optional ureteric stent: A temporary stent may maintain drainage while swelling settles. It may be left on a retrieval string for removal in clinic, or removed later using flexible cystoscopy. You will receive an individual removal plan.
10. Optional bladder catheter: A bladder catheter may also be used temporarily. It drains the bladder and is held in position by a small balloon.
11. Recovery and discharge: After the anaesthetic, you will be monitored in recovery. Many patients leave the same day once comfortable, stable and able to pass urine. Some may stay overnight.
12. Expected symptoms and warning signs: Temporary burning, urinary frequency, light blood staining and stent discomfort can occur. Seek urgent medical advice for fever or chills, severe or worsening pain, difficulty passing urine, heavy bleeding or clots, or if you feel significantly unwell. After surgery, you will be given the hospital and secretarial contact numbers to use if you need advice.
13. Individual treatment and closing message: The steps, likelihood of clearing the stone in one procedure and recovery depend on the stone, your anatomy and your circumstances. Your urologist will explain the recommended approach, its benefits and risks, and any follow-up you may need. This video provides general patient education and does not replace individual medical advice.