What is an URSL Surgery?

Ureteroscopic Lithotripsy (URSL) is a minimally invasive surgical procedure used to treat stones located in the ureter. It involves using a small, flexible or rigid ureteroscope passed through the urethra and bladder into the ureter to visualize, fragment, and remove the stones. URSL is often chosen for stones that are too large to pass naturally, cause severe symptoms, or have not responded to other treatments.

Indications for URSL

URSL is recommended for patients with:

• Ureteral Stones: Stones located in the ureter, particularly if they are causing blockage or severe pain.
• Failed Other Treatments: When non-invasive methods such as medical expulsive therapy or ESWL have not been successful.
• Symptomatic Stones: Stones causing significant pain, infection, or obstruction.
• Stones Resistant to Passage: Stones that are unlikely to pass on their own due to size or location.

Procedure of URSL

The steps involved in URSL are as follows:

1. Anesthesia: The patient is given general or spinal anesthesia to ensure comfort during the procedure.
2. Access: A ureteroscope is inserted through the urethra and bladder into the ureter.
3. Stone Visualization: The surgeon uses the ureteroscope to locate the stone.
4. Fragmentation: The stone is broken into smaller pieces using a laser, pneumatic device, or other lithotripsy techniques.
5. Stone Removal: The fragments are removed using a basket-like device or allowed to pass naturally through the urinary tract.
6. Stent Placement: In some cases, a temporary ureteral stent may be placed to ensure proper drainage and healing.

Advantages of URSL

• Minimally Invasive: No external incisions are required, leading to reduced pain and quicker recovery.
• Effective for Ureteral Stones: High success rate for removing stones in the ureter.
• Short Hospital Stay: Patients can often go home the same day or the next day.
• Low Complication Rate: Reduced risk of complications compared to open surgery.

Risks and Complications of URSL

While URSL is generally safe, some potential risks include:

• Infection: Risk of urinary tract infection (UTI).
• Bleeding: Although minimal compared to other procedures, there is still a small risk of bleeding.
• Ureteral Injury: Possible damage to the ureter during the procedure.
• Residual Stones: Some fragments may remain and could require additional treatment.
• Stent Discomfort: If a stent is placed, it may cause discomfort or the need for additional procedures to remove it.

Conclusion

URSL is an effective and minimally invasive option for treating stones in the ureter, offering a high success rate and quicker recovery compared to traditional surgical methods. Understanding the indications, procedure, benefits, and potential risks can help patients make informed decisions about their treatment options. If considering URSL, consult with a healthcare professional to discuss the best treatment plan for your specific situation.