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.

233 Responses to Ureteroscopy

  1. 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?

  2. 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.

  3. 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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