Dr. Julie Riley

You're right. And I still am telling my patients that. I think one of the things that has really changed and one of the things I see in my practice is there is a huge use of blood thinners, right? I don't know about you, but I have definitely seen that there is more and more and more and patients have to be on these. It's harder and harder to get them off of them.

And ureteroscopy, I do them on blood thinners. So I don't need to stop that. Whereas in a PCNL or shockwave, I need to stop those. And so I think that that's another big thing. It's a little less stressful than doing a PCNL. There's a lot more fluid shifts in PCNLs. There's a lot more to consider in PCNLs in terms of risks and lung injury, bleeding risk.

And ureteroscopy, I do them on blood thinners. So I don't need to stop that. Whereas in a PCNL or shockwave, I need to stop those. And so I think that that's another big thing. It's a little less stressful than doing a PCNL. There's a lot more fluid shifts in PCNLs. There's a lot more to consider in PCNLs in terms of risks and lung injury, bleeding risk.

And ureteroscopy, I do them on blood thinners. So I don't need to stop that. Whereas in a PCNL or shockwave, I need to stop those. And so I think that that's another big thing. It's a little less stressful than doing a PCNL. There's a lot more fluid shifts in PCNLs. There's a lot more to consider in PCNLs in terms of risks and lung injury, bleeding risk.

Yeah, those are small, but they're very unique to that procedure. And I'm seeing a lot more sick patients walk in my door that their lungs are not that good. They really can't handle the risk of bleeding. And so that pushes me more into ureteroscopy And so I'm pushing the limits of what it can do because sometimes my patients are sort of pushing what I have to do to get that stone out.

Yeah, those are small, but they're very unique to that procedure. And I'm seeing a lot more sick patients walk in my door that their lungs are not that good. They really can't handle the risk of bleeding. And so that pushes me more into ureteroscopy And so I'm pushing the limits of what it can do because sometimes my patients are sort of pushing what I have to do to get that stone out.

Yeah, those are small, but they're very unique to that procedure. And I'm seeing a lot more sick patients walk in my door that their lungs are not that good. They really can't handle the risk of bleeding. And so that pushes me more into ureteroscopy And so I'm pushing the limits of what it can do because sometimes my patients are sort of pushing what I have to do to get that stone out.

It never ceases to amaze me whenever you're like, oh gosh, I didn't really realize that somebody as frail as you could manage to get a stone that just has to get treated because it's obstructing and it's getting you sick. And it's just amazing how many more sick patients are coming in like that.

It never ceases to amaze me whenever you're like, oh gosh, I didn't really realize that somebody as frail as you could manage to get a stone that just has to get treated because it's obstructing and it's getting you sick. And it's just amazing how many more sick patients are coming in like that.

It never ceases to amaze me whenever you're like, oh gosh, I didn't really realize that somebody as frail as you could manage to get a stone that just has to get treated because it's obstructing and it's getting you sick. And it's just amazing how many more sick patients are coming in like that.

I treat them the same and I have not noticed any difference with that. They certainly do have a little bit more bleeding risk, but really nothing that's been significant change in terms of the way that their management afterwards are needing to come in more or something like that. So I treat them the same.

I treat them the same and I have not noticed any difference with that. They certainly do have a little bit more bleeding risk, but really nothing that's been significant change in terms of the way that their management afterwards are needing to come in more or something like that. So I treat them the same.

I treat them the same and I have not noticed any difference with that. They certainly do have a little bit more bleeding risk, but really nothing that's been significant change in terms of the way that their management afterwards are needing to come in more or something like that. So I treat them the same.

And it's true, right? There's that patient that you're like, I had no idea that you could possibly need to get this ureteroscopy. Awesome. I'm so excited I get to do it.

And it's true, right? There's that patient that you're like, I had no idea that you could possibly need to get this ureteroscopy. Awesome. I'm so excited I get to do it.

And it's true, right? There's that patient that you're like, I had no idea that you could possibly need to get this ureteroscopy. Awesome. I'm so excited I get to do it.

No, I think that we covered a lot in this, Jose. I think this was really good.

No, I think that we covered a lot in this, Jose. I think this was really good.

No, I think that we covered a lot in this, Jose. I think this was really good.

Yeah, I appreciate it.