Please have any pathology or radiology tests competed if requested during your appointment. Take your normal medications unless told otherwise by Dr Murray or the anaesthetist. Please notify Dr Murray if you are taking any blood thinners. The procedure requires a general anaesthetic therefore you will need to fast for six hours prior to the procedure. Please ensure someone has been arranged to drive you home after the procedure.

After administration of the anaesthetic a rigid cystoscopy is performed, and a guidewire inserted up to the kidney under x-ray guidance. The flexible pyeloscope is then inserted over this guidewire and advanced up to the kidney. The internal lining of the kidney is examined and any stones located. These stones are then either removed with a basket or fragmented into very small pieces using a laser.

At the end of the procedure a ureteric stent is inserted. This is a plastic tube that allows urine to drain from the kidney into the bladder after the procedure. If a stent was not placed the kidney would block off due to swelling or stone fragments obstructing the ureter. This would result in very severe pain. The stent stays in for one to two weeks.

A short period of time is required in the recovery room while the anaesthetic wears off. Expect to have pain and discomfort in the flank and in the lower abdomen, pain medication will be given by the nursing staff.

The ureteric stent irritates the bladder. Pain, discomfort and a sensation of needing to urinate often occurs. Expect to see blood in the urine and experience a burning sensation when voiding for as long as the stent is in. The severity of these symptoms are highly variable between patients and can not be reliably predicted prior to the procedure. Severe pain and discomfort occasionally occurs and may inhibit your ability to work. Unfortunately, the ureteric stent is an essential part of this procedure and is required to stay in for one to two weeks while the ureteric swelling settles.

Dr Murray will see you prior to discharge to discuss the findings, make arrangements for the ureteric stent to be removed and to confirm your follow up appointment.

Removal of ureteric stent: The ureteric stent is removed by passing a small flexible telescope (flexible cystoscopy) in to the bladder via the urethra. The stent is grasped with an instrument and withdrawn from the bladder. This procedure is done under intravenous sedation for your comfort. It requires admission to hospital as a day surgery case and attracts an additional fee.

Thankfully serious complications following flexible pyeloscopy are rare. Risks and complications include but are not limited to:

1. Haematuria (blood in the urine)

2. Dysuria (stinging sensation when voiding)

3. Urinary urge and frequency (from the ureteric stent)

4. Pain in the flank

5. Urinary tract infection

6. Incomplete clearance of stone (additional procedure required)

7. Ureteric injury from the telescope or stones (rare less than 1% risk)