Ureteroskoopia

Ureteroskoopia, also known as ureterorenoscopy or ureteroscopy in English, is a minimally invasive endoscopic procedure that enables direct visualization of the ureter and the renal pelvis. The examination is performed by inserting a ureteroscope through the urethra, into the bladder, and then up the ureter. Flexible or semi-rigid scopes allow access to different parts of the upper urinary tract. The term ureteroskoopia appears in some languages as a variant of ureteroscopy.

Indications for ureteroskoopia include evaluation of unexplained hematuria when other imaging is inconclusive, assessment and treatment of upper-tract stones, investigation of ureteral strictures, and assessment of urothelial tumors or other upper tract abnormalities. It can be diagnostic and, in many cases, therapeutic. During the procedure, stones can be fragmented with laser energy (commonly holmium:YAG) or other devices and the resulting fragments retrieved with baskets. Strictures may be treated with endoscopic incision or dilation, and a ureteral stent may be placed to ensure drainage during healing. The approach can be tailored to the location and size of stones or lesions and to patient anatomy.

Preparation and technique typically involve anesthesia (general or regional), use of a ureteral access sheath to facilitate repeated instrument passage, and imaging guidance with fluoroscopy. Antibiotic prophylaxis is commonly used. In some cases, pre-stenting the ureter weeks beforehand can improve access.

Risks are generally low but can include ureteral injury or perforation, infection or sepsis, bleeding, ureteral stricture, and postoperative pain or difficulty with drainage. Recovery is usually short, and many procedures are performed on an outpatient basis, depending on the complexity and patient factors.