A ureteroscopy is an examination or procedure using a ureteroscope. A ureteroscope, like a cystoscope, is an instrument for examining the inside of the urinary tract. A ureteroscope is longer and thinner than a cystoscope and is used to see beyond the bladder into the ureters, the tubes that carry urine from the kidneys to the bladder. Some ureteroscopes are flexible like a thin, long straw. Others are more rigid and firm. Through the ureteroscope, the doctor can see a stone in the ureter and then remove it with a small basket at the end of a wire inserted through an extra channel in the ureteroscope. Another way to treat a stone through a ureteroscope is to extend a flexible fiber through the scope up to the stone and then, with a laser beam shone through the fiber, break the stone into smaller pieces that can then pass out of the body in the urine. How and what the doctor will do is determined by the location, size, and composition of the stone.
Rigid cystoscope (left) and semirigid ureteroscope (right).
The reasons for a ureteroscopy include the following conditions:
frequent urinary tract infections
hematuria
unusual cells found in a urine sample
urinary blockage caused by an abnormal narrowing of the ureter
a kidney stone in the ureter
an unusual growth, polyp, tumor, or cancer in the ureter
What are the preparations for a cystoscopy or ureteroscopy?
People scheduled for a cystoscopy or ureteroscopy should ask their doctor
about any special instructions. In most cases, for cystoscopy, people will be
able to eat normally in the hours before the test. For ureteroscopy, people may
be told not to eat before the test.
Because any medical procedure has a small risk of injury, patients must sign
a consent form before the test. They should not hesitate to ask their doctor
about any concerns they might have.
Patients may be asked to give a urine sample before the test to check for
infection. They should avoid urinating for an hour before this part of the test.
Usually, patients lie on their back with knees raised and apart. A nurse or
technician cleans the area around the urethral opening and applies a local
anesthetic so the patient will not experience any discomfort during the test.
People having a ureteroscopy may receive a spinal or general anesthetic. They
should arrange for a ride home after the test.
Urinary tract infection (UTI) is an infection of the kidney, ureter, bladder, and/or urethra. Not
everyone with a UTI has symptoms. Common symptoms include a frequent urge to
urinate and a painful, burning when urinating.
One in every 20 people develop a kidney stone at some point in their life. A kidney stone is a hard mineral and crystalline material formed within the kidney or urinary tract. Kidney stones symptoms and signs are, blood in the urine and pain in the abdomen, flank (lower back), or groin. A number of different conditions can lead to kidney stones including: gout, hypercalciuria, people with inflammatory bowel disease, kidney disease, and hypoparathyroidism. Some medications also increase the risk of kidney stones.
Treatment for bladder cancer depends on the stage of the disease, the grade of the tumor, and the type of bladder cancer. Options for treatment include surgery, radiation therapy, chemotherapy, and biological therapy.
Cancer is a disease caused by an abnormal growth of cells, also called malignancy. It is a group of 100 different diseases, and is not contagious. Cancer can be treated through chemotherapy, a treatment of drugs that destroy cancer cells.
Interstitial cystitis (IC) is an inflammatory disease of the bladder that can cause ulceration and bleeding of the bladder's lining and can lead to scarring and stiffening of the bladder. Symptoms of interstitial cystitis may vary among individuals and may even vary with time in the same individual.
Overactive bladder is a sudden involuntary contraction of the muscle wall of the bladder causing urinary urgency (an immediate unstoppable need to urinate). Overactive bladder is is a form of urinary incontinence. Treatment options may include Kegel exercises, biofeedback, vaginal weight training, pelvic floor electrical stimulation, behavioral therapy, and medications.
Benign prostatic hyperplasia (BPH or enlarged prostate) is very common in men over 50 years of age. This noncancerous enlargement of the prostate can impede urine flow, slow the flow of urine, create the urge to urinate frequently and cause other symptoms like complete blockage of urine and urinary tract infections. Treatment may involve watchful waiting, medication, or surgery.
Urinary retention (inability to urinate) may be caused by nerve disease, spinal cord injury, prostate enlargement, infection, surgery, medication, bladder stone, constipation, cystocele, rectocele, or urethral stricture. Symptoms include discomfort and pain. Treatment depends upon the cause of urinary retention.
A urethral stricture, or narrowing of the urethra, may cause decreased urine output. Symptoms include painful urination, urinary retention, and pelvic pain. Surgery is the only treatment for people with uncontrolled symptoms of urethral narrowing.
Schistosomiasis (snail fever), a disease caused by parasites, causes a variety of symptoms and signs, such as cough, rash and bloody diarrhea. Praziquantel is used in the treatment of schistosomiasis.
Millions of women suffer from urinary incontinence (UI). UI occurs twice as often in women as in men. There are many types of urinary incontinence: stress incontinence, urge incontinence, overactive bladder, functional incontinence, overflow incontinence, transient incontinence, and mixed incontinence.
Urethral cancer is a rare form of cancer that primarily affects white females, people over 60 years of age, and those who have stds or who experience frequent urinary tract infections. Symptoms and signs of urethral cancer include blood in the urine, interrupted urine flow and discharge from the urethra. Treatment involves surgery, radiation therapy, and chemotherapy.