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Laparoscopic Ureterolithotomy

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
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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 associated with any surgery include:

  • Adverse reaction to anesthesia, including light-headedness, low blood pressure, or wheezing
  • Infection
  • Excess bleeding
  • Heart attack or stroke
  • Blood clots
  • Death

Complications associated with ureterolithotomy include:

  • Excess scarring or narrowing in the ureter that can lead to kidney problems
  • Failure to remove the kidney stone
  • Problems urinating such as:
    • Urine leaking from the ureter
    • Difficulty passing urine, especially in men
  • Bowel complications:
    • May be blocked or paralyzed after surgery leading to bloating and vomiting
    • Scar tissue around bowels that can cause later blockages
  • Excess scarring of incision
  • Hernia

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 medicines you are taking. Do not start taking any new medicines, herbs, or supplements without talking to your doctor.
  • You may be asked to stop taking some medicines up to one week before the procedure. This may include medications such as:
    • Anti-inflammatory medications
    • Blood thinners
    • Anti-platelet medications
  • 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. Once 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 medicine.

Average Hospital Stay

The usual length of your hospital stay is two to four 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 three to four 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 medicine 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, take these steps:

  • Get plenty of rest. Gradually resume activities.
  • Drink plenty of fluids.
  • Follow your doctor’s instructions on cleaning the incision site.
  • Ask your doctor when you can drive and return to work.
  • Ask your doctor when it is safe to have sex.
  • Ask your doctor about when it is safe to shower, bathe, or soak in water.
  • Take medication as directed by your doctor.
  • 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 medicines you were given after the procedure
  • Pain that you cannot control with the medicines you have been given
  • Cough, shortness of breath, or chest pain

If you have an emergency, call for medical help right away.

Revision Information

  • National Kidney and Urologic Diseases Information Clearinghouse

    http://kidney.niddk.nih.gov

  • National Kidney Foundation

    http://www.kidney.org

  • Urology Care Foundation

    http://www.urologyhealth.org

  • Canadian Urological Association

    http://www.cua.org

  • The Kidney Foundation of Canada

    http://www.kidney.ca

  • Kidney stones in adults. National Kidney and Urologic Diseases Information Clearinghouse website. Available at: http://kidney.niddk.nih.gov/KUDiseases/pubs/stonesadults/index.aspx#treatment. Updated June 29, 2012. Accessed January 15, 2013.

  • 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. Accessed January 23, 2013.

  • 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 15, 2013.

  • 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 15, 2013.

  • Ureterolithotomy (removal of ureteric stone). The Pennine Acute Hospitals website. Available at: http://www.pat.nhs.uk/CubeCore/.uploads/Media%20Library/Abdomen/Urology/20120711%5F288%20Ureterolithotomy.pdf. Updated February 2009. Accessed January 15, 2013.

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