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Endourology

What is EndoUrology?

Any urological procedure done through an edoscope without putting an incision through a natural orifice or by making a small puncture is called endourological procedure.

Which are common endourological procedures?

For stones

  • PCNL
  • URS
  • RIRS
  • Cystolitholapexy

For Prostate

  • TURP
    • Saline TURP
    • LASER TURP

For Stricture Urethra

  • VIU

Tumors

  • TUR – BT

Bladder Stone

  • Cystolitholapexy

Others

  • D-J Stenting

PCNL (Per Cutaneous Nephro Lithotomy)

PCNL

It is a procedure where a stone in the kidney or upper part of ureter is removed by a small puncture in the flank.

Size of wound is from 3mm to 10mm with or without stitch.

Procedure is done under Anaesthesia, operative time is 30 minutes to 2 hours and hospitalization is for 2 days, needs 2 to 3 days of rest at home.

Stone free rate is almost 90 to 95%.

URS (Uretero Reno Scopy)

URS

It is a procedure where a stone in the ureter is removed by passing a small endoscope (Ureteroscope) through the External Urethral Opening. Ureteroscope is a Semi Rigid instrument with diameter varies from 2 to 4 mm.

Procedure is done under General on Spinal Anaesthesia, operative time is about 30 minutes, and hospitalization is for one day. Sometimes a stent (D J Stent) is kept after the removal of stone which needs to be removed after 2 to 3 weeks.

Strone free rate is more than 95%.

RIRS or Flexible Ureteroscopy

RIRS

In this procedure stone in the upper part of ureter or a stone less than 1.5 cm in the kidney is removed by passing a flexible scope through external opening.

Procedure is done under General Anaesthesia.Operative time is about one hour and a stent is kept at the end of procedure, which needs to be removed after 2 weeks.

Hospitalization time is one day and stone clearance rate is more than 90%.

Cystolitholapexy

In this procedure urinary bladder stone is removed by passing a scope through urethral opening.

Procedure is done under spinal or General Anaesthesia, operation time is about 30 minutes.

Hospitalization is for one day and patient can go back to routine activity after one day.

VIU (Visual Intenal Urethrotomy)

It is a procedure where stricture (Narrowing) of urethra is treated by passing a scope from urethral opening.

Procedure is done under Anaesthesia, time of procedure is 15-20 minutes and hospitalization is for one day.

After this procedure urethral catheter is kept for 4 to 5 days.

TUR-BT (Trans-Urethral Resection of bladder tumour)

This procedure is done to remove bladder tumour by passing a scope through urethra.

Procedure is done under General Anaesthesia, operative time is 30 to 60 minutes depend on the size of tumour.

Urethral Catheter is placed at the end of procedure, which is removed after 2 days and hospitalization is for 2 to 3 days.

D J Stenting

dj-stenting

It is a procedure where a stent (which is of 2mm diameter and 25-30 cm long tube) is kept through a scope.

It is self retaining tube which is placed from kidney to bladder.

Common indication of D J Stenting are obstructing stones, with high S. Creatinine or presence of pus in the kidney with obstruction.

Stents are temporary and needs to be removed once the underlying disease is treated.

Very rarely stents are kept for long duration in the disease where ureter are compressed (like cancer of cervix or Retro peritoneal tumour).