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Ureteroscopy and holmium laser lithotripsy for kidney stones

The Approach

Ureteroscopy is defined as upper urinary tract endoscopy performed most commonly with an endoscope passed through the urethra, bladder, and then directly into the upper urinary tract. Indications for ureteroscopy have broadened from diagnostic endoscopy to various minimally invasive therapies. Technological advancements have led to broader indications while minimizing peri-operative complications resulting in efficacious access to the upper tract. Flexible ureteroscopy allows access to all parts of the upper urinary tract and can be employed for the treatment of ureteral and kidney stones.

Endoscopic lithotripsy, treatment of upper urinary tract urothelial malignancies, stricture incisions, and ureteropelvic junction obstruction repair are all current treatments facilitated by contemporary ureteroscopic techniques. Because the application of ureteroscopic procedures has evolved from a diagnostic tool to a facilitator in complex therapeutic interventions, a proportional increase in the rate and severity of complications would be expected. However, with improved instrumentation and evolution of surgical technique, the complication rate associated with ureteropyeloscopy has actually decreased significantly.

 

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