Ureteroscopy
Ureteroscopy is a minimally invasive procedure, in which there are no incisions, done under general anesthesia. It is typically done for small to medium-sized kidney stones.
A very small scope, called a ureteroscope, is inserted into the ureter to visualize the kidney stone. The urologist can then visualize the kidney stone in real-time on a monitor and uses a laser to break the stone up into very small particles that can be passed spontaneously in the urine.
Some stone fragments are extracted and sent to a lab for analysis. Knowing the stone’s composition is critical to understanding what type of stone it is and informing what measures can be used to prevent the stone from coming back.
After the ureteroscopy, a thin plastic tube called a ureteral stent may be needed. The ureteral stent is placed in the kidney and leads to the bladder to allow urine to drain into the bladder while the child’s body heals from any swelling and inflammation caused by the stone and the procedure itself. The stent may be left in the kidney anywhere from a few days to a few weeks.
Children’s Hospital of Philadelphia’s Pediatric Kidney Stone Center offers ureteroscopy an outpatient procedure, meaning that after the surgery, a child can go home after recovering for about an hour or two.
It's essential to have an experienced, comprehensive, integrated team for kidney stone care. The team at CHOP’s Kidney Stone Center believes in partnering with patients and their caregivers to determine which surgery is best. The team explains the treatment options — including the likelihood of each completely clearing the stone and the surgical and postsurgical experience — and then partners with families to help them make the most informed decision possible.
In addition to removing existing stones, the center’s team partners with patients and caregivers to prevent future kidney stones. Patients return for follow-up every six months for metabolic testing and an ultrasound to help the team understand what factors are driving stone formation. Once specific risk factors for kidney stone recurrence are identified, the team partners with families to create a long-term prevention plan that works best for them and their child.
The center team is involved in ongoing research efforts dedicated to better understanding why kidney stones are occurring earlier in life and the factors that lead to kidney stones in children. Their hope is to develop better methods to prevent stones from being a recurring disease over a lifespan and improve treatment options for children with kidney stones.
