Ureteric stones are a common problem in daily
emergency department practice. In the last 20 years, options for the management
of this problem have changed radically. (Hollingsworth,
et al. , 2012) . Various factors such as size of calculi,
severity of symptoms, degree of obstruction, kidney function, location of stone
and presence or
absence of associated
infection influence the
choice of one
type of intervention over the
others (Dellabella , et al. , 2013) .
stones prevelence is relatively high, occurring in approximately 12% of
men and 7% of women. The risk is increased with a past history of ureteric
stone or with positive family history. Most patients present aged between 30 and
60 years of age, with peak incidence between 35-45 years old. Initial stones
presentation occurring past 50 years of age is uncommon (Tamm,
et al. , 2014) .
Ureteroscopic lithotripsy manipulation of a
stone is a commonly applied method of stone removal. The success rate of
ureteroscopy is over 90% for the majority of stones that are treated this way.
Successful stone clearance depends on the size of stone, location of the stone,
(where in the kidney or ureter), A small endoscope, which may be rigid, semi rigid,
or flexible, is passed into the bladder and up the ureter to directly visualize
the stone (Moore, et al. , 2014).
smaller than 5 mm in diameter generally are retrieved using a stone basket, a
surgeon can take exhaustive lithotripsy to allow for residual stones to pass
spontaneously. In large studies comparing this
approach, has been associated with higher stone-free rates (up to 100%),
lower rates of subsequent unplanned emergency department visits, and lower
rates of re-hospitalization (Tasian, et al. , 2016)
Ureteroscope is passed through natural body orifices and
involve no skin incisions, It is an outpatients` procedure. Certain patients` groups who cannot be treated
with percutaneous nephrolithotomy (PCNL) such as patients on
blood thinners , pregnant women , morbidly obese and airline pilots/astronauts) can be treated
safely and effectively by
ureteroscopy. After the surgery patient will be taken to the recovery room . Once pain is controlled and are able to
urinate, patient may be discharged from the recovery room to home ( Kupeli , et al. ,
2012 and Vincent & Bird , 2015) .
Nurses need to be aware that patients
with ureteric stone disease desire information about the condition and not just
at the time of diagnosis or development of symptoms. They can provide education
and facilitate support. It is important that the patient undergoing
ureteroscopic lithotripsy needs to be assessed to improve both the quality and
value of care for them (Gdor, et al . , 2014).
The health needs include: physical
such as: activities of daily living, physical preparation, general assessment,
interventional technique, investigations and treatment, post-procedural pain
management, control of nausea and vomiting, postoperative diet, complications
management and self-care post discharge. Psychological such as: reducing
anxiety from pain and complications and information about emotional health
lifestyle. Social such as: patient’s social activities, work, driving and
social support. Spiritual
such as: relation with God and motivation (Akram et al., 2010).