Nephrology and Urology

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Successful Bariatric surgery at We Care India partner hospital allows Robert Clarke to live a normal life despite a rare genetic disorder We Care india helped Robert find best super specialised surgeon for his rare condition.

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There is a stone in the tubing, in the ureter, that runs from your kidney to your bladder. You have two kidneys, a left and a right one. They are each about the size of a fist. They lie deep in your back on each side of your spine, in front of the lowest rib on each side. They make the urine which passes down the ureter on each side to the bladder just below your navel. Stones from the kidney can pass down the ureter causing pain, blood in the urine, infection, or can block the ureter causing pressure on the kidney. Often the stones pass right through by themselves. In your case, however, the stone has stuck in the ureter. It needs to be taken out with an operation.

Before The Operation

Stop smoking and try to get your weight down if you are overweight. If you know that you have problems with your blood pressure, your heart, or your lungs, ask your family doctor to check that these are under control. Check the hospital's advice about taking the Pill or hormone replacement therapy (HRT). Check you have a relative or friend who can come with you to the hospital, take you home, and look after you for the first week after the operation. Sort out any tablets, medicines, inhalers that you are using. Keep them in their original boxes and packets. Bring them to the hospital with you.

On the ward, you may be checked for past illnesses and may have special tests to make sure that you are well prepared and that you can have the operation as safely as possible.. Please tell the doctors and nurses of any allergies to tablets, medicines or dressings. You will have the operation explained to you and will be asked to fill in an operation consent form. Many hospitals now run special preadmission clinics, where you visit for an hour or two, a few weeks or so before the operation for these checks.

The Operation

You will have a general anaesthetic, and will be asleep for the whole operation. Sometimes the stone in the ureter can be pulled out by a special telescope passed up into your bladder through the normal urine passage. Otherwise a cut has to be made into the skin. The stone is then taken out through an opening in the side of the ureter. The wound is then stitched up. If the stone can be removed with the special telescope, you should be able to leave hospital within 24 hours. Otherwise you should allow seven days or so in hospital.

After - At Home

After the open operation, you are likely to feel very tired and need to rest two to three times a day for a week or more. You will gradually improve so that by the time a month has passed you will be able to return completely to your usual level of activity. After the special instrument procedure you should be back to normal duties inside a week. At first discomfort in the wound will prevent you from harming yourself by lifting things that are too heavy. After two months you can lift as much as you used to lift before the operation.. There is no value in attempting to speed the recovery of the wound with special exercises before this. You can drive as soon as you can make an emergency stop without discomfort in the wound, i.e. after about three weeks. You can restart sexual relations within three weeks or so, when the wound is comfortable enough. You should be able to return to a light job after about one month and any heavy job within two months.

Possible Complications

As with any operation under general anaesthetic, there is a very small risk of complications related to your heart and lungs. The tests that you will have before the operation will make sure that you can have the operation in the safest possible way and will bring the risk for such complications very close to zero. For both types of operations, complications are relatively rare. If you think that all is not well, please ask the doctors and the nurses.

Chest infections may arise, particularly in smokers. Do not smoke. Getting out of bed as quickly as possible, being as mobile as possible and co-operating with the physiotherapists to clear the air passages is important in preventing a chest infection.

Sometimes there is blood in the urine. If the doctors expect this, a catheter is usually put in at the time of the operation. It may take some days to clear. You will need to stay in hospital until it gets better.

Sometimes you can have an infection which is either localised in your urinestream or gets into the bloodstream. You will be given antibiotics to treat the infection.

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