Unlike traditional rigid ureteroscopes, fiberoptic ureteroscopes are soft endoscopes that can be bent at the apex at will, so they can reach areas of the kidney that are inaccessible to traditional rigid ureteroscopes, and without causing any superficial damage, fiberoptic ureteroscopes can lithotripsy the kidney through the body’s natural lumen. However, “minimally invasive” does not mean low risk. Since the fiberoptic ureteroscope is slightly thicker than the normal ureter, it is necessary to pre-treat the ureteral dilatation before the lithotripsy procedure in order to advance This can avoid serious complications such as ureteral injury and sepsis due to ureteral stenosis in some patients. The most effective way to pre-dilate the ureter is to leave a stent in the ureter, which is clinically known as the “double pigtail” or “double J tube”. Ureteral stent placement can be accomplished through an outpatient cystoscopic procedure under local anesthesia, and the stent is left in the ureter for 2 weeks or more to adequately and passively dilate the ureter. Patient education for fiberoptic ureteroscopic lithotripsy A standard fiberoptic ureteroscopic lithotripsy procedure at Beijing Friendship Hospital is as follows: 1. Initial outpatient visit, billing appointment for outpatient cystoscopy, ureteral stent placement and subsequent 2-week admission for fiberoptic ureteroscopic lithotripsy. You will need to be tested for hepatitis B, hepatitis C, HIV and syphilis at this visit, so be sure to keep the results for all subsequent outpatient and inpatient procedures. 2. Ureteral stents will be placed for outpatient cystoscopy from 9:00 a.m. to 12:00 p.m. Every Tuesday, you need to drink more water before cystoscopy. There is no drainage tube on the body surface after stent placement, which does not affect daily activities, and oral antibiotics are taken for 3 days after surgery. It is best to drink more than 3 liters of water per day, drinking pure water, not mineral water. Some patients may experience complications such as lumbar distension, painful urination, urinary urgency, urinary frequency and hematuria during the indwelling ureteral stent, which generally do not require special treatment. (The outpatient operating room is located on the 5th floor of the outpatient clinic.) 3. 2-3 weeks after the indwelling ureteral stent, patients will be admitted to the hospital for fiberoptic ureteroscopic lithotripsy, and the duration of this admission will be about 3-5 days. The ureteral stent will be placed again after the fiberoptic ureteroscopic lithotripsy to facilitate the discharge of stone debris and to keep the ureter open and avoid urinary tract infection. 4. Ureteral stents are usually removed 2-4 weeks after surgery if there are no special circumstances. In 2-4 weeks after the operation, we need to review the patient’s outpatient clinic and make an appointment for outpatient cystoscopy to remove the double pigtail tubes. 5. Patients with very large stones may require 2 or more procedures to break up all the stones, with an interval of 2-4 weeks between each procedure. Note: Fiberoptic ureteroscopy is a lithotripsy procedure, not a stone removal procedure. Large stones in the patient’s body are broken up by the holmium laser during the fiberoptic ureteroscopy, resulting in a large number of stone fragments 1-3 mm in diameter. Most of the stone fragments are actively flushed out of the patient’s body during the procedure, but a small percentage of stone fragments remain in the kidney and ureter and need to be expelled after the procedure. The methods to promote stone discharge are: ① increase water intake, for patients after fiber ureteroscopy lithotripsy, if there are no other contraindications, it is better to drink more than 3 liters of pure or distilled water daily, not mineral water, tap water and other water containing more ions; ② more exercise to promote the discharge of stones in the ureter, but for patients with a large number of lithotripsy at once, the process of stone discharge should not be too hasty, so as not to However, for patients who have a large number of stones discharged into the ureter at the same time, the process of stone removal should not be rushed to avoid the formation of “stone streets” blocking the ureter; ③ For stones located in the lower renal calyces, the stones need to be moved up into the renal pelvis first and then fall into the ureter for discharge. The patient should lie prone on the bedside, with the upper body out of the bed, and make the head as close to the ground as possible, so that the upper body is in the position of head low and waist high, then let someone else strike the middle of the patient’s back (the 12th rib and the spinal column angle) for 10-20 seconds, walk and jump upright for 10-20 minutes, lie prone on the bedside again with the head low and tap the back, and so on 4-5 times/day. After the completion of all surgeries, it is necessary to maintain the habit of exercising more, drinking more water, eating a low protein diet, refraining from eating tofu or soy products, and eating less vegetables with high oxalic acid content. For uric acid stones, it is necessary to visit the rheumatology department to reduce the blood uric acid level by taking medication, avoiding animal offal and drinking beer. The entire consultation process including pre-operative billing, outpatient surgery appointment, post-operative appointment for ureteral stent removal, post-operative review, etc. can be seen at the clinic of this group of doctors. The clinic hours of this group of doctors are as follows: Li Jun: Wednesday morning, Thursday morning Xiao Jing: Tuesday morning, Wednesday afternoon