Uretheroscopic Lithotripsy (URSL) – Holmium Lasar
This is an endoscopic procedure involving the ureter stones done using min-socpes. It is a day procedure done under general anaesthesia and fluoroscopic Xray guidance. This is a rigid or flexible cable like ureteroscope which is passed in to the ureter via the urethra.
Once the ureteroscope reaches the designated site of the stone, a laser pulse is used to break the stone into tiny pieces which will pass out on its own. A wire basket can be used along with the ureteroscope to extract the broken pieces. This is a surgery that at best lasts 30 minutes and so can be easily done as a day care case under general anaesthesia.
For stones lodged in the lower ureter there is 100% result while stones lodged in the mid-upper ureter may break and float up into the kidney. If the flexible ureteroscope is used, this is easily solved since the scope can flex back within the kidney calyces to retrieve the stone.
URSL has an advantage over other procedure in that even hard stones can be broken with ease and the ureter opening can be dilated to facilitate stone passage.
PCNL or Percutaneous Nephrolithotomy is used for stones that are too large, too numerous or too dense to be treated by shock wave lithotripy or ureteroscopy. PCNL is best described as a minimally invasive method of removing all kinds of urinary stones.
TURP (Transurethral Resection of Prostate)
A TURP is a surgery to remove parts of the prostate gland through the penis without any incision. The surgeon reaches the prostate by inserting an instrument in to the end of the penis and through the urethra. This is a resectoscope which is about 12 inches long and 5 inch in diameter. There is a lighted camera at the end of the cable and valves that control irrigating fluid. It also contains an electrical loop that can cut tissues and seal the blood vessels. The wire loop is in fact the tool that helps a surgeon remove the tissue that is blocking the urethra. The pieces of tissue are carried by the irrigating fluid to the bladder and later flushed out along with urine.
Retrograde Intrarenal Surgery (RiRS)
This is a procedure that is done inside the kidney with a viewing tube. It is popularly known in the medical circles Fibre Optic Endoscopy. This is the result of an unprecedented advancement in medical technology that it is possible to carry ou the procedure in the treatment of kidney stone.
The procedure is performed to remove kidney stones, which can bee seen through the endoscope and later it is crushed or blased using ultrasound or evaporated using laser probe and sometimes removed manually using a pair of small forcerps.
Cystoscopy is a procedure that allows the doctor to examine the lining of the bladder and the urethra in detail. A hollow tube called cystoscope is equipped with a lens which is inserted into the urethra and slowly advanced into the bladder.
The procedure is usually done in a testing room, using local anaesthetic jelly to give numbness to the urethra. It is done as an outpatient procedure with proper sedation. Cystoscopy can be done in the hospital using general anaesthesia.
Trans urethral removal of bladder tumour (TURBT)
Trans urethral removal of bladder tumour is the removal of tumour in the bladder through the urethra. The urethra is the tube that carries urine from the bladder to the outside. The procedure is usually performed under general anaesthetics and it is also a procedure that helps to look inside the bladder (cystoscope).
The procedure is done using a flexible tube called cystoscope. The optic fibres in the cystoscope emits light and has an eyepiece at the end which the surgeon uses to see down the cystocope and perform the procedure by looking at the images on the monitor. The surgeion also passes small instruments down the cystoscope to slice out tumours from the bladder lining.
This is surgical procedure for the removal of body tissue in the urethra called Optical Internal Urethrotomy, This is a direct visual internal Urethrotomy. Where the surgeon uses an endoscopic device, which is called a Urethrotome to look inside the urethra and uses a sharp surgical tool to make incision to remove the tissue in the urethra. This is a popular treatment for urethral strictures and is used to remove unwanted tissues.