URSL Surgery

URSL is a combination of the following two procedures:

1. Ureteroscopy: It is a type of medical procedure which involves the use of a special instrument called a ureteroscope to locate problems like kidney stones inside the ureter.
2. Laser lithotripsy or laser stone fragmentation: This procedure involves the use of a laser or sound waves to break the kidney stones into small pieces so that they can easily travel through the urinary tract and then pass out of the body.

Types:
The different types of URSL surgeries are:

1. Ultrasonic lithotripsy: This procedure involves the use of sound waves to break up kidney stones.
2. Electrohydraulic lithotripsy: The kidney stones are broken into tiny pieces using electrical shock waves in this type of procedure.
3. Extracorporeal shock wave lithotripsy: This procedure involves the use of sound waves to break a very large kidney stone into tiny pieces. This type of treatment may need multiple sessions.

Symptoms

URSL may be recommended in the following cases:

1. Kidney stones 
2. Urine blockage
3. Urinary tract infection
4. Pain during urination
5. Decreased frequency of urination
6. Radiating pain in the abdominal area

Diagnosis

1. Physical examination: The doctor will check the overall physical health of the patient and note the symptoms of the patient.
2. Urinalysis: The patient’s urine is analyzed to check the presence of essential minerals.
3. Blood tests: Blood tests like complete blood count (CBC) test helps in the overall evaluation of blood and the detection of various disorders such as anemia. Blood coagulation profile (PT / PTT) is a test performed to check the amount of time taken by the blood to clot. A blood urea nitrogen (BUN) test gives important information on how well the patient’s kidneys are functioning.
4. Electrocardiogram (ECG): This is a test performed to evaluate the electrical activity of the heart.
5. Imaging tests: Tests like x-rays, abdominal ultrasounds, and MRI scans help in obtaining images of the kidney and ureter and check the precise location and size of the kidney stones.

Treatment

1. This procedure may be performed under general anesthesia (the patient is put to sleep during the procedure) or spinal anesthesia (the patient is numbed from the waist downwards).
2. A ureteroscope (a thin tube that comes with a tiny camera and light on one end) is inserted through the urethra (a tube that drains urine from the bladder) and into the ureter (a tube connecting the bladder to the kidneys).
3. X-rays are used simultaneously to guide the surgeon to the areas in the areas in the kidney and ureter where the stones are present.
4. Once the stone is located, the surgeon will pull it out using a stone basket.
5. In the case of a large kidney stone, a laser or ultrasonic waves are used to break the kidney stones into smaller fragments. These stone fragments are then flushed out through the urine.
6. The surgeon may insert ureteral stents to help in flushing out kidney stones from the body. The stent will expand the ureter passage, which will make it easy for the stone fragments to travel through the ureter and out of the body. 
7. The procedure takes less than one hour to complete.

Risks

The complications associated with URSL include:

• Infection
• Pain
• Bleeding
• Fever
• Chills
• Fatigue
• Nausea
• Constipation 
• Burning sensation during urination
• Decrease in urgency or frequency of urination
• Extreme pain in the lower back
• Injury to the ureter
• Hematuria (blood in urine)

After Procedure

• It is normal to have mild to moderate bladder or flank pain after the surgery.
• You may have some pain while urinating or may have frequent urination for a few days after the surgery.
• You may see some blood in your urine until you have recovered completely.
• You can usually resume your daily activities within five to seven days of undergoing the surgery.
• Have regular follow-up appointments with your doctor to monitor your progress.

Home remedies:

The following home remedies may be useful in having a smooth and quick recovery after a URSL surgery:

1. Drink lots of fluids to keep the urine flowing frequently. This helps in flushing out blood clots that could continue to form for some time as a part of the healing process.
2. Take a laxative to avoid straining during bowel movements.
3. Avoid strenuous activities and climbing the stairs for at least four weeks after surgery.
4. Avoid driving or taking long car rides for a few weeks after surgery.
5. Avoid heavy lifting for four weeks after surgery.
6. Take the pain-relieving medications recommended by your doctor properly.
7. Eat a healthy, fiber-rich diet and reduce the consumption of salt, animal proteins, and oxalate-rich foods to prevent kidney stones from recurring.

Benefits:

URSL has the following advantages over conventional surgeries:

• Quicker recovery
• Minimally-invasive procedure
• No need for incisions or cuts 
• Fewer complications
• Shorter stay in the hospital
• Patient can resume normal daily activities within a week
• Restoration of kidney function
• Prevention of painful urine passage
• Prevention of permanent kidney damage
• Prevention of severe infections like septicemia (blood poisoning)
• Elimination of bladder blockage possibility 

Cost of URSL Surgery- 

The cost of URSL surgery in Mumbai is between INR 40,000 to INR 1,10,000.
The cost of URSL surgery in Delhi is between INR 35,000 to INR 1,00,000.
The cost of URSL surgery in Bangalore is between INR 35,000 to INR 1,00,000.
The cost of URSL surgery in Chennai is between INR 30,000 to INR 85,000.