A Guide Through Open Ureterolithotomy Surgery.

: Admin : 2022-06-01

Suppose pain is felt while urinating, unable to empty the bladder fully, urine containing blood, infection in urine, or spray urine are you complaining about. In that case, there is a possibility that is a possibility that your urethra is narrowing. The doctor may suggest tests from the mentioned symptoms like an X-ray of the urethra or ultrasound, retrograde urethrogram, urethroscopy, cystoscopy, postvoid residual (PVR) volume, or just physical examination.

 After the diagnosis is made and based on that result, the doctor will decide on the surgery whether to undergo a urethrotomy or not. The surgery of removal of stone from the ureter is open ureter lithotomy. There is a tube named the ureter between the bladder and the kidney. Through this tube, the urine is passed down to the bladder.

Removal of a stone from the uterus through surgery. A narrowed urethra is widened by passing through a surgical knife in this outpatient surgery. Criticisms of the urethral are very rare in women. Generally, in men, a urethrotomy is performed.

Reasons 

The doctor will only perform the surgery if he finds the mentioned symptoms in the patient though he will perform some tests before confirming the surgery. These reasons are

· Unable to empty the bladder fully

· Blood in the urine and causing pain

· Infection of the urine

· The flow of urine is blocked

· Stones are too large to pass the urine

· Creating 

pressure on the kidney

· The urine comes out as spray.

Before the Surgery

To know the stricture severity and length, a cystoscopy test will be suggested by the doctor. To check whether the patient is otherwise in a good health state, the doctor may also suggest doing some blood tests. To ensure that no bacteria is there, the doctor may also suggest a urine test. An ECG (heart electrocardiogram) may also be needed depending on the existing or any pre-existing heart condition and your age. There must be an explained discussion of your medical history with the doctor who will perform the surgery. Every minor detail should be shared. The patient is expected to all the drugs he is consuming currently and for what reason, as the meditation process may require a break for some days or weeks before and after the operation. The doctor will go through the possibility of risks while operating. They will provide you with a bond that needs to be signed by the patient or someone in authority over the patient. There is a consent form and should be only signed when everything is written there and must be read carefully, and every word is understood as clearly as a crystal. If any part of any section has any doubt and is not clear, feel free to ask the doctor or hospital authority.

Operation Procedure

On the abdomen or the side, a cut will be made depending on the exact position of the stone. To expose the ureter, both the skin and the muscles need to be incised. Then the location of the stone will be searched. Just above the stone in the ureter, a cut will be made, and then the

stone will be removed then. Placement of stent will be done in the ureter to help to keep the opening of the ureter by this device. After this, the ureter will be shut and stitched closed. The muscles and skin will also be shut by stitching and sewing. A tube will be placed in the wound for any extra fluid to drain out and let the wound heal. The removed stones may be sent to a laboratory for further testing. The operation may take from 60 to 90 minutes. The patient will be taken to the recovery room after the operation. An X-ray may be performed to confirm that the stones have been removed properly. Though the anesthesia prevented the pain during the operation, some medicine is required to get through the pain.

Post-Procedure

Oxygen may be required for a short period by the patient. A tube is placed where a slit is done to drain out the extra fluid; when the fluid stops draining, it will be removed from the incision. Within 3-4day of surgery, this happens. There will be an IV unit until you are drinking and eating normally. Until you can move around to drain your urine, a catheter will be attached. Some medicine to decrease your pain will be provided. After surgery, you will be encouraged to walk. To prevent blood clots, some blood-thinning medicines may also be given.

Complications 

Though the possibility of complications is very rare in this process, some risk factor is contained in any surgery. Some common complications that the doctor will also review are infection, heart attack or stroke ( some patients cannot sustain the pressure of a surgery), excessive blood loss ( during surgery, blood loss will be common, but sometimes excessive bleeding occurs), adverse reaction of anesthesia (anesthesia don't work the same for all, the result may be adverse for some patient), blood clots, blockages of bowel, hernia, failing in the removal of kidney stone, the ureter is narrowed excessively which can lead to kidney problems, an incision is scarred excessively, the last one is the ultimate death.

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