Flexible ureteroscopy update: indications, instrumentation and technical advances
Srinivas Rajamahanty1, Michael Grasso
1St Vincent's Medical Center Campus, New York Medical College, New York, USA.
Summary
Retrograde ureteroscopy is now used for complex therapies beyond diagnostics. Advances focus on smaller, sturdier instruments to improve minimally invasive treatments and manage complications effectively.
Area of Science:
- Urology
- Minimally Invasive Surgery
Background:
- Retrograde ureteroscopy indications have expanded significantly.
- The field has evolved from diagnostic procedures to complex therapeutic interventions.
Purpose of the Study:
- To review recent advancements in retrograde ureteroscopy.
- To cover new instrumentation, expanded indications, surgical techniques, and complications.
Main Methods:
- Literature review of recent advances in retrograde ureteroscopy.
- Analysis of new instrumentation, accessories, and surgical techniques.
- Examination of reported complications and outcomes.
Main Results:
- Instrumentation is becoming smaller and more robust.
- Indications for retrograde ureteroscopy have broadened considerably.
- Surgical techniques and complication management are continually improving.
Conclusions:
- Retrograde ureteroscopy is a versatile tool for complex urological conditions.
- Ongoing innovation in instrument design is crucial for therapeutic success.
- Further research into optimizing techniques and minimizing complications is warranted.
Related Concept Videos
Imaging Studies V: Intravenous Urography and Retrograde Pyelography
IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
Urinary Tract Calculi VI: Surgical Management
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
Urologic Endoscopic Procedure: Cystoscopic Examination
Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
Imaging Studies II: Ultrasonography
IntroductionUltrasonography, or renal ultrasound, is a noninvasive medical imaging technique that uses high-frequency sound waves to visualize the kidneys, ureters, bladder, and surrounding tissues.Indications for Urinary System UltrasonographyUrinary system ultrasonography is indicated in various clinical scenarios, such as:Kidney Stones (Urolithiasis): To detect and monitor the size and presence of kidney or urinary tract stones.Hydronephrosis: To assess the dilation of the renal pelvis and...
Urinary Tract Calculi III: Medical Management
The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
Ureters
The ureters are retroperitoneal tubes located on either side of the vertebral column. They are responsible for transporting urine from each kidney to the urinary bladder. These tubes have thick walls and are approximately 25-30 cm long. Their diameter is around 10 mm at the renal pelvis, gradually narrowing to 1 mm as the ureter obliquely enters the posterior bladder wall through the ureteric orifices. The shape of these orifices is slit-like, which helps to prevent urine backflow toward the...
