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What complications could occur following a ureteroscopy

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during which a kidney stone...
What complications could occur following a ureteroscopy during which a kidney stone was found lodged in my friend's ureter? They used a laser to break up the stone while the scope was in the ureter. The procedure was done 3 months ago and he still has intermittent sharp pain in the area of the ureter where the stone was. He is a 59 year old man in good health. The urologist just keeps saying, "We roughed you up in there, it'll take some time to heal." Could the ureter wall be damaged or could part of a stone lodged in the wall?
Submitted: 6 years ago.Category: Urology
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Answered in 3 minutes by:
3/8/2012
Urologist: DrRussMd, Board certified internist replied 6 years ago
DrRussMd
DrRussMd, Board certified internist
Category: Urology
Satisfied Customers: 65,671
Experience: In internal medicine we deal with prostate, bladder and kidney diseases, including cancers.
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Hello
There is unlikely to be stone left at all this would cause extreme pain and illness.

And it would be constant pain.

Infection can be a complication but that would show up in urinalysis.

Scarring or narrowing of the ureter, very rarely might be possible.

However, I would consider 3 months to still be having occasional stabs of pain to be within normal...but it should be getting gradually and noticeably better.

Let me know if you have further questions, details or need clarification, just use reply.......

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Customer reply replied 6 years ago
Called my friend who said I am not correct, the pain is not intermittent, it is constant, every day, a 3 or 4 on a scale of 1-10. Jogging or situps makes it worse. Yesterday he had a renal scan and his bladder was extremely full, and the pain became severe (7 or 8) in ureter at stone site. Renal scan results were "fine" per doctor. He wants to know if the laser could have damaged the ureter?
Urologist: DrRussMd, Board certified internist replied 6 years ago
it could, but that would show up on scan if severe damage.

He could have some scarring or even a stone with this story.
Only an IVP would be fully definitive as a test.
Have him ask his docs about this.

.

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Customer reply replied 6 years ago
What's the difference between an IVP and a renal scan?
Urologist: DrRussMd, Board certified internist replied 6 years ago
There is
ultrasound of the renal system
CT
MRI
IVP
IVP uses dye which would show narrowing, even a small amount.
good luck

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Customer reply replied 6 years ago
He just had a renal scan with dye--is that the same as an IVP?
Why would the renal scan make the pain so much worse? No stone showed in the scan. No narrowing showed in ureter.
Urologist: DrRussMd, Board certified internist replied 6 years ago
it can also be a nuclear scan, but i bet IVP
So he has inflammation
That is going to take more time.
One can have some reaction to the dye
good luck
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Customer reply replied 6 years ago
Relist: Incomplete answer.
I think we need a urologist! I want to know what could cause severe pain in ureter at site where kidney stone was broken up with laser 4 months ago. Recent renal scan clear. Renal scan caused greatly increased pain. Why would this be?
Urologist: Dr. Y., Urologist replied 6 years ago
Dr. Y.
Dr. Y., Urologist
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Satisfied Customers: 20,398
Experience: I am fellowship trained specializing in general urology and reconstructive urology.
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Anytime an instrument or laser is used in the ureter, this can lead to the development of scar tissue called a stricture. This can cause pain during the page of urine. If you had pain when the renal scan was done, this is further proof that there is some sort of obstruction there, even if the renal scan was supposedly "normal". I would recommend either a CT IVP or a test in the operating room called a retrograde pyelogram to determine if there is any subtle area of narrowing that may need to be repaired or dilated. If the urologist who did the renal scan is not willing to further investigation, then it is time to get a second opinion from a urologist at a university medical center. Hope this helps.
Dr. Y.
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