Ureterolithotomy

A loyalty program is available for surgical interventions in the hospital, which makes treatment even more affordable.

Ureterolithotomy - this is a surgical operation performed to remove ureteral stones. It is prescribed when conservative treatment and lithotripsy (transurethral stone crushing) are ineffective. The essence of the operation is to dissect the ureter and remove the stones.

Depending on the indications, ureterolithotomy is performed:

• laparotomy - through open access;

• laparoscopically - through several punctures in the abdominal wall.

In most cases, surgeons at «Oxford Medical» Ureterolithotomy is performed laparoscopically. This is a modern minimally invasive technique that involves the use of high-tech equipment. It allows you to do without a wide incision by making 3-4 punctures with a diameter of about 1 cm on the abdominal wall or side wall of the abdomen. They are used to insert a laparoscope equipped with a video camera and trocars with special surgical instruments.

Laparoscopic ureterolithotomy is less traumatic than open access surgery. This reduces blood loss, the risk of postoperative infection and other complications. The length of hospitalization is reduced from 1-2 weeks to 2-4 days, and rehabilitation is easier and faster.

Open surgery is performed in the most complex cases when the use of the laparoscopic method is impossible.

Urolithiasis can develop as a result of a complex of various disorders in the body.

The main causes are considered to be:

• genetic predisposition;

• abnormalities in the development of the urinary system;

• nephroptosis (kidney prolapse);

• chronic and infectious diseases of the genitourinary system;

• metabolic disorders;

• endocrine diseases;

• pathologies of the gastrointestinal tract;

• long-term use of certain drugs;

• unbalanced diet;

• insufficient fluid intake;

• sedentary lifestyle, etc.

Even after treatment, urolithiasis can recur, so patients are recommended to adjust their lifestyle to reduce the impact of risk factors, as well as regularly undergo examinations by a urologist.

One of the complications of urolithiasis is obstruction of the ureter by a calculus. It occurs when a stone gets stuck in the ureter and partially or completely blocks its lumen. Obstruction leads to impaired urine outflow, which can later cause hydronephrosis, atrophy of the renal parenchyma and renal failure.

The need for ureterolithotomy most often occurs with complete obstruction of the ureter. This condition is called a renal colic and is accompanied by severe pain. The operation is the most radical method of treatment and is performed when other types of therapy are ineffective or impractical.

Ureterolithotomy may also be recommended if the patient requires surgical intervention for another pathology. In particular, the operation is often combined with ureteroplasty for hydronephrosis.

Before lithotomy of calculi, the patient undergoes a comprehensive examination. Based on its results, the indications for surgery are clarified, the optimal method of surgical intervention is selected, and contraindications are excluded.

The examination may include:

• Ultrasound of the urinary system;

• Excretory urography;

• Computed tomography (according to indications).

• Blood and urine tests.

Consultation with an anesthesiologist and doctors of other specialties may also be required if the patient has chronic diseases.

It is recommended to stop taking medications that affect blood clotting 2 weeks before the operation. After 2-3 days, you should switch to a light diet, and on the day of the operation, you should refrain from food and water.

To prevent infectious complications, the patient may be prescribed antibiotics.

Previously, ureterolithotomy was performed only through open access. It requires a wide incision, which is associated with the risk of complications and long-term rehabilitation. Now this method is resorted to only in severe cases, when the patient has contraindications to laparoscopy.

The laparoscopic method is preferable, but it requires high professionalism from the surgeon and the availability of new equipment in the clinic.

In «Oxford Medical» all conditions have been created for performing both open ureterolithotomy and laparoscopic. Most often, our surgeons use the second method.

Laparoscopic ureterolithotomy is performed as follows:

1. The patient is put under anesthesia.

2. After that, the skin in the operation area is treated with an antiseptic.

3. Using a special needle, carbon dioxide is injected into the abdominal cavity to raise the abdominal wall and increase the working space.

4. 3-4 punctures with a diameter of about 1 cm are made on the abdominal wall or side wall of the abdomen and a laparoscope equipped with a video camera with a built-in LED and a trocar with surgical instruments are inserted through them.

5. The image from the camera is transmitted to the monitor screen and magnified many times, which allows the surgeon conduct a thorough examination and, using manipulators, with maximum precision perform dissection of the ureter, removal of calculi, restoration of the integrity of the ureter and installation of a temporary stent.

6. After completing the surgical manipulations, the surgeon conducts a second examination, removes the instruments and sutures the puncture sites.

After the operation, the patient remains in the intensive care unit for some time. There, he gradually comes out of anesthesia, remaining under the constant supervision of specialists.

After that, the patient is transferred to a surgical hospital. It is equipped with comfortable single and double hotel-type wards with a private bathroom.

On the day of the operation, bed rest is recommended. The next day, the patient's urethral catheter is removed, after which, provided that he feels well, he is allowed to get up, walk a little and gradually resume eating.

The hospitalization period is usually from 2 to 4 days.

At first, the patient may feel pain in the area of ​​the postoperative wound, nausea, and weakness. To eliminate symptoms, prevent infectious complications and recover, the doctor prescribes painkillers, antibacterial, anti-inflammatory and other drugs according to indications.

Until complete recovery, the patient is recommended to avoid heavy lifting and heavy physical exertion. They are also advised to follow a special diet: give up drinking alcoholic beverages, salty, spicy, sour, smoked and fried foods, replacing them with natural products, steamed or boiled. Such a diet reduces the load on the kidneys and serves as a prevention of the re-formation of stones.

Providing high-quality medical care using modern, effective and safest methods is one of the main priorities of "Oxford Medical". For this purpose, the clinic has installed the latest expert-class equipment and assembled a team of experienced, highly qualified doctors.

The cost of removing stones in the ureter may vary depending on:

• the method of treatment (the patient may be shown transurethral lithotripsy, laparoscopic lithotomy or another procedure);

• the number, location, size and density of the stones;

• the type of anesthesia (local anesthesia, spinal anesthesia or general anesthesia).

Find out the cost of crushing and surgical removal of stones at «Oxford Medical» you can here. A urologist will advise you more precisely on the price, taking into account individual characteristics, during a preliminary consultation. Make an appointment at a time convenient for you.