Ureteroscopy and Fulguration Lesion

Why is it done?

• Viewing suspicious lesions in upper urinary tracts (ureter and renal pelvis)
• Flexible uretero-renoscopy to review inside of the renal pelvis and renal calyces
• Removal of the lesion using laser
• Rigid is better for the ureteric inspection

How is it done?

• Patients will receive general anaesthesia.
• Prophylactic antibiotics are given.
• The correct kidney is identified and marked while you are awake
• You would have had a cystoscopy with retrograde pyelogram 10 days prior with the placement of a ureteric stent to prepare your ureter
• A cystoscopy will be done first to remove the stent, and 2 guidewires will be placed to enable access up the ureter
• Depending on the position of the lesion, either a rigid or flexible uretero-renoscope will be used.
• Suspicious lesions may be biopsied and fulgurated.
• Laser fulguration or Diathermy may be used.
• Catheters will be removed the next morning depending on the presence of blood in the urine
• Extended use of a ureteric stent may be advised, depending on the degree of bleeding

Complications

• Ureteric perforation
• Stricturing / Narrowing
• Disruption of ureter
• Stent Irritation
• Procedure abandoned due to bleeding

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Wes Ureteroscopy and Fulgeration lesion

Copyright 2019 Dr Jo Schoeman