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Laparoscopic Ureterolithotomy

(Removal of Stones in Ureter)
  • Definition

    Laparoscopic ureterolithotomy is a procedure to remove stones from the ureter. The ureter is a tube between the kidney and the bladder. Urine passes down to the bladder through this tube.
    Laparoscopic procedures use small incisions and specialized tools. This helps to avoid large incisions that are used during open surgery.
    The Urinary Tract
    IMAGE
    Copyright © Nucleus Medical Media, Inc.
  • Reasons for Procedure

    Ureterolithotomy is used to remove stones in a ureter that:
    • Are too large to pass
    • Cause pain or bleeding
    • Cause infection
    • Block the flow of urine
    • Place pressure on the kidney
  • Possible Complications

    Problems from this surgery are rare, but all surgeries have some risk. Your doctor will review potential problems. Complications may include:
    • Adverse reaction to anesthesia
    • Infection
    • Excess bleeding
    • Blood clots
    • Excess scarring or narrowing in the ureter that can lead to kidney problems
    • Failure to remove the kidney stone
    • Excess scarring of incision
    • Problems urinating
    • Problems having bowel movements
    • Hernia
    • Heart attack or stroke
    • Death
    Smoking may increase your risk of complications.
    Talk to your doctor about these risks before the procedure.
  • What to Expect

    Prior to Procedure
    • Your doctor may do the following:
      • Images of your urinary system to locate the stone
      • Blood and urine tests
      • Ask about your medical history
    • Talk to your doctor about any medications you are taking. Do not start taking any new medications, herbs, or supplements without talking to your doctor.
    • You may be asked to stop taking some medicines up to 1 week before the procedure.
    • Arrange for a ride home from the hospital. Arrange for help at home as you recover.
    • The night before your surgery, eat a light meal. Do not eat or drink anything after midnight unless told otherwise by your doctor.
    Anesthesia
    General anesthesia will be used. You will be asleep. It is given through a vein in the arm or hand.
    Description of the Procedure
    A few small incisions will be made in your abdomen. Specialized tools will be inserted through the incisions. The tools will be used to make an incision in the side of the ureter. The stone will be removed through this incision. A stent may be placed in the ureter. This will support the ureter while it heals. The incision in the ureter will be closed with stitches. A drain may be put in place. It will help fluids drain from the area while you heal. When the tools are removed, the incisions in the abdomen will be closed with stitches. Bandages may be placed over the incisions.
    The stone may be sent to a laboratory for testing after surgery.
    Immediately After Procedure
    After the operation, you will be taken to the recovery room for observation.
    How Long Will It Take?
    About 60 minutes
    How Much Will It Hurt?
    Anesthesia prevents pain during surgery. As you recover, you may have some pain. Your doctor will give you pain medication.
    Average Hospital Stay
    The usual length of your hospital stay is 2 to 4 days. If you have any problems, you may need to stay longer.
    Post-procedure Care
    At the Hospital
    • You may need oxygen for a brief time after your operation.
    • You will have a tube near your incision. It will drain blood and fluid from the area. The tube may be removed within 3 to 4 days of surgery.
    • You may have an IV until you are eating and drinking normally.
    • You will have a catheter that will drain your urine.
    • You will be given pain medication as needed.
    • You may be encouraged to exercise by walking soon after surgery.
    • You may be given blood thinning medication to prevent clots.
    At Home
    When you return home, be sure to follow your doctor's instructions.
  • Call Your Doctor

    Call your doctor if any of these occur:
    • Extreme urge or inability to urinate
    • Excess bleeding
    • Bruising
    • Redness or swelling at the site of the incision
    • Pus draining from the site of the incision
    • Signs of infection, including fever and chills
    • Nausea and/or vomiting that you cannot control with the medications you were given after the procedure
    • Pain that you cannot control with the medications you have been given
    • Cough, shortness of breath, or chest pain
    If you have an emergency, call for emergency medical services right away.
  • RESOURCES

    National Kidney and Urologic Diseases Information Clearinghouse http://kidney.niddk.nih.gov

    Urology Care Foundation http://www.urologyhealth.org

    CANADIAN RESOURCES

    Canadian Urological Association http://www.cua.org

    The Kidney Foundation of Canada http://www.kidney.ca

    References

    Kidney stones in adults. National Kidney and Urologic Diseases Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/KUDiseases/pubs/stonesadults/index.aspx. Updated January 28, 2013. Accessed January 12, 2015.

    Patient Information: Open removal of stone from ureter. Addenbrooke’s Hospital NHS website. Available at: http://www.camurology.org.uk/wp-content/uploads/ureterolithotomy-44.pdf. Updated April 2014. Accessed January 12, 2015.

    Skrepetis K, Doumas K, et al. Laparoscopic versus open ureterolithotomy. A comparative study. Eur Urol. 2001;40(1):32-6.

    Ureterolithotomy—dormia basket. Netdoctor website. Available at: http://www.netdoctor.co.uk/surgical-procedures/ureterolithotomy-dormia-basket.htm. Updated June 7, 2009. Accessed January 12, 2015.

    Ureterolithotomy (open) consent form. Queensland Government website. Available at: http://www.health.qld.gov.au/consent/documents/urology%5F21.pdf. Published March 2011. Accessed January 12, 2015.

    Revision Information

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