Nefroskopia

Nefroskopia, or nephroscopy in English, is an endoscopic examination of the kidney that uses a nephroscope to directly visualize the renal pelvis and calyces. It is employed to assess intrarenal anatomy, manage stones, obtain tissue samples, and perform certain intrarenal procedures.

Two main approaches are used. Percutaneous nephroscopy involves creating a small tract through the skin into the renal collecting system, typically for stone removal or fragmentation. Retrograde nephroscopy, using a flexible ureteroscope passed through the urethra, bladder, and ureter to reach the renal collecting system, allows intrarenal evaluation and treatment with less external disruption. Flexible nephroscopes enhance maneuverability within the complex intrarenal anatomy.

Indications include evaluation and management of complex renal stones not readily treated by other means, assessment of intrarenal anatomy in cases of suspected renal pathology, selective renal biopsies, and certain intrarenal procedures such as stone fragmentation, dilation, or retrieval of calculi. It may also aid in diagnosing unexplained hematuria or guiding other endourological treatments. Contraindications include uncorrected coagulopathy, active severe infection, and anatomic or medical conditions that preclude safe access to the renal collecting system.

Equipment and technique involve rigid and flexible nephroscopes, imaging guidance, controlled irrigation, guidewires, stone baskets, lithotripsy devices, and anesthesia. The procedure requires specialized endourology facilities and trained personnel.

Risks and limitations include bleeding, infection, injury to renal parenchyma or collecting system, urinary leakage, stone migration, and sepsis, as well as the need for anesthesia and potential postoperative recovery. Nephroscopy has evolved since its mid-20th-century development, and remains a key component of modern endourology, especially in percutaneous stone surgery and intrarenal diagnostics.