Ureteroscopy

Diagram of ureteroscopy and laser lithotripsy

Ureteroscopy involves the use of a small flexible or rigid device called a ureteroscope to directly see and treat stones. The ureteroscope device, which provides a video image and has small “working” channels, is inserted into the bladder and up the ureter until the stone is encountered. The stone can then either be broken up with a laser fiber or pulled out using small baskets that are inserted into the working channels. The advantage of this type of surgery is that the body’s normal openings are used and no incisions are necessary. A photo of a flexible ureteroscope and a video of ureteroscopy with laser lithotripsy is shown below.

Diagram of ureteroscopy and laser lithotripsy

Flexible ureteroscope treating a stone in a kidney

Ureteroscopy often a good option for small stones in the ureter or kidney. Its success rate at clearing these types of stones is generally higher than that for shockwave lithotripsy. Compared with shockwave lithotripsy however, it may associated with increased discomfort after surgery, especially when a stent is required. Ureteroscopy also does  not always work as well with very large stones, as the small size of the instrument makes it difficult to completely treat and remove such stones. In these cases a percutaneous approach may be preferable. For more information on comparing the surgical options for kidney stones, see our comparison chart.

 

Fast facts about ureteroscopy:

  • Typical operative time: 1 hour
  • Usual hospital stay: Usually none, ureteroscopy is outpatient surgery
  • Average number of days before going back to work: 8.5 days
  • Average number of days before feeling back to normal: 15.6 days

Data regarding return to work and recovery from a study by Pearle and colleagues, Journal of Urology, 2005.

Ureteroscope closeup photo

Photo of a ureteroscope next to a pen

 

Video of flexible ureteroscopy and holmium laser lithotripsy in a patient with multiple large uric acid stones.

240 Responses to Ureteroscopy

  1. Daniel Brewington says:

    I had a ureoscopy in Jan. they told me that i had four stones and it would take about an hour. I woke up almost four hours later and they told me I had over 10. Here it is 8 months later and I have passed three stones with two weeks with a horrible amount of pain. I am scared to use the restroom knowing that any second I could be going through the worst pain I ever felt

  2. Robert Hill says:

    8.5 days before going back to work? 16.5 before feeling normal. My doctor said nothing about limitations at all. I’m going back tomorrow, four days after the procedure.

    I wonder about one thing though. He mentioned something about scar tissue, but did not specify where. On Friday, the day after, I jacked one out, normal except I peed blood for several hours after.

    Today, Sunday the 11th, did the same, with the same results.

    Why would my urologist not mention abstaining from sexual activity if it is harmful to the recovery? He mentioned no limitations at all. Did he assume, that because I’m 55, I don’t do such things anymore? False assumption, I assure you. I do it at least twice in any given 24 hour period. Sometimes three times. Still feels the same at 55, as it did in my 20’s. Still the same amount at the end as well.

    If the scar tissue he mentioned is at, or around my prostate, and will prevent me from enjoying sexual release the rest of my days, I’m outta here soonest. I can live without a lot of things. That is not one of them.

  3. Robert Hill says:

    Well, tomorrow is the big day. Can’t wait! Right!! It’s got to be done. Got all the pre-op stuff done today. Sister is taking me and bringing me home. I’m assured that everyone who has undergone this at the facility I’m having it done at has had no pain issues at all. I’m told I won’t even know the stent is in there, except for having to sign a form acknowledging my knowing it’s there. 😉

    • Piper Pierce says:

      I hate to say this but I just got home from having stone removed and I can barely breath I am hurting so badly. My doc forgot to leave a pain script and it is too late to get one. Thanks to the freaking drug addicts.

  4. Robert Hill says:

    I have a 9mm stone stuck in my right ureter not too far from my kidney. Having this procedure done Thursday September 8th 2016. After all the reading, not looking forward to it one bit. But I really don’t have much choice, the stone has apparently been there since I felt the pain in mid July. When I tried to get an appointment with my urologist, I had to wait until August 30th, a frickin month and a half. I now have Severe Hydonephrosis, my kidney is all swollen up as is my ureter. Told I may end up losing the kidney, even after the procedure is done. They’re going to place a stent, which I don’t like. But my dad just had one removed, and he said it didn’t bother him the slightest. Hope it’s the same for me. But who the h-e-double-toothpicks knows.

  5. Yean Loon says:

    Pain in my left flank started 23rd July. Went to hospital and initial diagnosis was Renal Colic. X-rays proved inconclusive. Given painkillers and left. Follow-up appt 3 weeks later. Urologist asked a few questions and scheduled a CT scan in 5 weeks. And an appt with him 2 weeks later. All this while, not much pain, but on 2 occasions saw blood in urine.
    Decided to get a 2nd opinion.

    The 2nd urologist found a 6x3mm stone in my right ureter on the 20th Aug. It was weird cuz all my pain has been on the left side. Doc recommended surgery saying the area around the ureter was swollen and i probably won’t be able to pass out the stone by myself. Scheduled ureteroscopy on 25th and after the surgery, he couldn’t find the stone!

    Anyone has any thoughts?

  6. Janie Dotson says:

    I had 6mm stone removed July 26th, no stent thankfully, this is my 3rd stone removal. Went for my final recheck on 08/15/16, told doc I felt like I had uti, he said, no my urine was clear. 1:10 pm that day, I was passing blood and clots in my urine the size of dimes, with severe burning, painful, and frequent urination. Finally heard back from doc today, got script for ciproflaxin for possible infection, but they are stumped on the blood clots, thought maybe it was caused by my procedure 3 weeks ago. Any ideas?

  7. Mike Frost says:

    I had the Ureterostomy on 7/23 and without reservation, the worst pain I have ever felt time 10. I recommend that you stay one night at the hospital with an experienced staff in post Kidney stone pain management. I also had a tremendous amount of blood. After about 2 to 4 hour post op with the excruciating pain they placed a catheter. Oh what a relief, but still more blood, and then the pain came back. Not quite as bad but in continual spasms that I still rate at the 10 level. As I got through the night the pain went from 10 to 8 to 5 and still a lot of blood. I ended up staying two more nights to make sure there were no other complications and to manage the pain. I will have the stent removed in about eight days. I wonder if there are “old” fashioned type stents because I have read about the one you can remove yourself. Even though I hear some say it is easy and not overly painful, I am concerned.

  8. Rob Riddel says:

    Date: 7/24/16.
    I am a 55 year old male. I had a 6mm x 10mm stone removed 5 days ago with laser treatment and then they installed a stent. My procedure lasted 70 minutes. They sent me home with prescriptions (Morphine for pain), but it was so late to have them filled, the pharmacy where I lived was closed. So I relied on taking left over oxycodene pills I had from my ER visit a few days before the surgery. Big mistake. The pain I experience after the surgery was 5 times greater than the actual kidney stone pain. The burning during urination was so bad, I panicked every time I had to urinate. Today is day 5 and I feel fine. I have to have the stent removed in a week from now. I am not looking forward to that. Drink plenty of water. One thing I have to mention that helped me with the pain. The first night after my surgery was the worst ever. Up all night. I used heat patches on my back to alleviate the pain. It worked for me somewhat. I recommend trying these options because they worked for me. I downloaded an app on my cell phone that reminds me to drink a glass of water. Works great. Good luck all.

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