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