Procedure for URS with DJ stenting

URS surgery stands for Ureteroscopic Lithotripsy. In this an ureteroscopy (scopy = procedure done for examining internal body structures with the help an instrument with a camera) which is usually done for ureteric calculi. This procedure is done under general anaesthesia; an ureteroscope is passed through urethra in bladder upto the ureter.

URS surgery is a minimally invasive surgical intervention done with the objective of removing kidney stones by a small telescope. In this procedure, the scope is passed from the urethra into the ureter. With the help of a laser fibre instrument called lithoclast probe, kidney stones are fragmented. The tiny pieces usually pass by themselves; however, when they cannot, then the remaining pieces are removed by a wire basket device.

Indications for URS With DJ Stenting

Indications for ureteroscopy can be classified into:

1. Diagnostic indications
2. Therapeutic indications

1. Diagnostics indications are as follows:
• Filling defect
• Determining the cause of obstruction
• Haematuria (unilateral)
• Identifying the cause of abnormal/positive results of:
  • Urinary cytology
  • Culture results

Evaluating the cause of trauma to the ureter

2. The therapeutic indications are as follows:
   • Ureteral strictures
   • Endoscopic lithotripsy
   • Improving calyceal drainage
   • Calyceal diverticular lesions
   • Malignant urothelial tumors
   • Benign tumors and bleeding lesions

An URS with double-J (DJ)stentis required in the following cases:

• Injury to the wall of the ureter
• Pre-existing hydronephrosis (caused by retention of urine because of obstructed free flow of urine from the kidney) of the kidney due to the impacted stone.

URS With DJ Stenting Complications

The complications of URS with DJ stenting include:

• With the stent movement a high possibility of the stent penetrating into the neighboring organs like: bladder, kidneys, lungs, etc. cannot be denied.
• When the stent is in place for a long time; there is also a high risk of an inherent bladder infection
• As a result of the prolonged insertion, a risk of a further dislocation/blockage
• Increased urge to urinate
• Urine Leakage
• Haematuria (Blood in the urine)
• Kidney pain symptoms
• In the rarest cases, the stent might fracture inside the body.
• Fever

The Average Length of Stay

This procedure usually takes 30 minutes (hence it can be done in a day patient setting).

Approximate Cost of URS With DJ Stenting

URS with DJ stenting costs starts approximately from $ 1500 onwards.