Ureteroscopy

Ureteroscopy is a procedure that removes stones and stone fragments. It doesn't require an incision and is usually performed under general anesthesia.

The doctor passes a small telescope (called a ureterscope) through the urethra and bladder and up the ureter until the stone can be seen. Small stones are often removed in one piece. Larger stones are broken using a laser and pieces of the stone are removed. A stent (small tube) may be left in the ureter for several days after treatment to make sure that the kidney drains well.

Is ureteroscopy right for me?

Ureteroscopy may be a good option for:

Stones in any location in the ureter or kidney
Stones that may or may not be seen on an x-ray
Stones smaller than 1.5 cm, anywhere in the urinary tract
In very carefully selected situations, patients with who cannot be safely treated by ESWL or PCNL may be treated by ureteroscopy. For example, people who are on blood thinners for heart or blood clotting disorders may be treated without stopping their medication and pregnant women may be safely treated during pregnancy.

Ureteroscopy may NOT be a good option for those with:

Large stones - Destruction of stones greater than 15 mm may generate too many fragments to completely clear.
History of bladder or ureteral reconstruction - Patients who have had their bladders removed for cancer or who have had major bladder or ureteral reconstruction may be poor candidates for ureteroscopy.

Chronic urinary tract infection - The only way to stop chronic infection associated with kidney stones is to completely remove the stones. To minimize the chances of leaving fragments behind, percutaneous surgery may be a better option for patients with larger stones (about 10 mm).

What is the treatment success rate?

Success rates are generally high because the stone or stone fragments are removed. It is very unusual for patients to require any further treatment after ureteroscopic stone treatment. At the HealthEast Kidney Stone Institute, 95% of patients who undergo ureteroscopy require only a single treatment.

What should I expect after treatment?

After ureteroscopy, most patients experience irritation of the bladder and urethra. You may have to urge to urinate frequently and feel some burning when urinating. Many of these symptoms are due to irritation from the stent. You may also experience blood in your urine, as well as some discomfort from the stent.

Call your doctor if you experience:

Increasing pain - May be sign of ureteral injury or blockage
Heavy bleeding or blood clots - May be a sign of ureteral injury
Fever - May indicate a kidney infection
Feeling unwell - It is OK to feel tired but it is not OK to feel sick

What follow-up is required after ureteroscopy?

Ureteral stents are generally removed a week after the procedure, during a doctor's visit. A CT scan is usually performed one month after the procedure if a laser was used to break up the stone. The scan checks on the kidneys and makes sure that all stone fragments have been cleared.