Kidneyoscopy

A Kidneyoscopy is mainly used to remove kidney stones from the ureter and / or the kidney. It can be performed by two methods: a transurethral and a percutaneous kidneyoscopy. Both procedures are reliable, but risks must be expected with every endoscopy.

What is the kidney mirror?

A Kidneyoscopy can be done in two ways: either transurethrally, i.e. through the urethra, or percutaneously, i.e. through the skin. With a transurethral mirror (ureterorenoscopy, URS) the ureter and the kidneys are mirrored, whereby the percutaneous procedure (percutaneous nephrolitholapaxy, PCNL / PNL) focuses only on the inner cavity of the kidney (the renal pelvis). The latter method is very effective but is much more invasive than the former. Both procedures are performed under anesthesia.

A direct kidneyoscopy or Nephroscopy is a so-called percutaneous procedure, which means that it is carried out through the skin. Since the skin is cut open, the kidneyoscopy is rarely performed to establish a diagnosis. The main purpose of the procedure is to remove kidney stones.

For a ureteral and kidneyoscopy, the instrument is passed through the bladder into the ureter. Ideally, the attending physician can push the device up to the kidney in order to remove the kidney stones there. In both procedures, the doctor works with uninterrupted control by an ultrasound device or a camera.

Function, effect & goals

The Kidneyoscopy is a therapeutic method. The most important function of the percutaneous kidneyoscopy is to remove kidney stones, which are found in the inner cavity of the kidney and, because of their size, cannot pass through the ureter.

The large kidney stones that cannot be smashed are also removed by the percutaneous kidneyoscopy. Stones with a diameter of 3 cm or more are removed in this way. With kidney congestion, a kidneyoscopy can also help by draining the urine from the kidney pelvis. Kidney congestion occurs when the urine cannot flow out towards the bladder because of a congestion in the ureter.

In a percutaneous kidneyoscopy, the patient has to lie on his stomach so that the attending physician can make an incision through the skin on the side of the abdomen. This incision enables an endoscope to penetrate and advance to the kidney. Thus the inner cavity of the kidney, the renal pelvis, is punctured.

The whole process is controlled with an ultrasound device because it is a very precise procedure and because otherwise the doctor would not be able to see exactly where the endoscope is. After the instrument is inserted, a medical "jackhammer", laser, or ultrasound will shatter the stone and remove the fragments directly.

During a ureterorenoscopy, the stones are removed “naturally”. The instrument is passed through the bladder into the ureter, possibly up to the kidney. The stones are either pulled out or, if they are too big, crushed beforehand using laser beams or ultrasound. In this procedure, too, the steps are followed directly. Thanks to modern technology, very small cameras can be accommodated at the top of the device.

The ureter is usually prepared for the procedure by inserting a splint. This splint is used to relax the ureter, which makes the procedure less risky.

Risks, side effects & dangers

As with all medical procedures, the Kidneyoscopy Dangers and Complications. These include intra- or post-operative bleeding or injuries to the ureter and renal pelvis.

In addition, a fever can occur as a consequence of the procedure. Very rarely, kidney loss can occur. It can happen that the rinsing fluid that is needed for the reflection gets into the bloodstream. This thins the blood.

Neither a transurethral nor a percutaneous procedure may take place in the event of an untreated urinary tract infection. In the case of coagulation disorders, the two methods are only recommended in urgent cases. A percutaneous kidneyoscopy is prohibited during pregnancy. This method is also contraindicated in the case of a tumor in the access area.

The likelihood of the above complications depends on the size and location of the stones or previous operations.