Description

Transurethral Lithotripsy (TUL) is a minimally invasive procedure used to treat stones in the urinary tract, particularly in the ureters and kidneys. Here’s a comprehensive overview:

Familiarity with Treatment

TUL is a well-established procedure for managing urinary stones. It involves breaking down stones into smaller fragments that can be passed naturally or removed more easily.

Procedure

1. Preparation: Patients are usually advised to fast for several hours before the procedure and may need to stop certain medications. Preoperative imaging tests are often conducted to locate the stones.
2. Anesthesia: The procedure is performed under general or spinal anesthesia.
3. Ureteroscope Insertion: A ureteroscope, a thin tube with a camera and instruments, is inserted through the urethra and bladder into the ureter.
4. Stone Fragmentation: The stones are located and broken into smaller pieces using laser or ultrasonic energy.
5. Removal: The fragments are either removed with a basket-like device or left to pass naturally through the urine.
6. Completion: The procedure typically takes 30 minutes to an hour and is often done on an outpatient basis¹².

Who is it Suitable For?

• Patients with stones in the ureters or kidneys that are causing symptoms or complications.
• Individuals who have not responded to other treatments like medication or extracorporeal shock wave lithotripsy (ESWL)³.

Who is it Not Suitable For?

• Patients with very large stones that may require more invasive surgery.
• Those with certain anatomical abnormalities or severe infections¹.

Advantages

• Minimally invasive with no external incisions.
• High success rate in fragmenting and removing stones.
• Shorter recovery time compared to open surgery².

Complications

• Infections: Including urinary tract infections.
• Bleeding: Some blood in the urine is normal, but excessive bleeding requires medical attention.
• Ureteral Injury: Rare but possible.
• Stone Fragments: Some fragments may remain and require additional treatment¹².

Previous Care

• Follow preoperative instructions from the healthcare provider.
• Ensure all medications and supplements are discussed with the provider.

Aftercare

• Rest: Avoid strenuous activities for a few days.
• Hydration: Drink plenty of fluids to help pass any remaining stone fragments.
• Monitor: Watch for signs of infection or excessive bleeding.
• Follow-up: Regular check-ups to ensure all stones have been removed and to monitor for recurrence¹².