About Ureteroscopy (URS)

Ureteroscopy is a procedure to address kidney stones, and involves the passage of a small telescope, called a ureteroscope, through the urethra and bladder and up the ureter to the point where the stone is located. Ureteroscopy is typically performed under general anesthesia, and the procedure usually lasts from one to three hours.

If the stone is small, it may be snared with a basket device and removed whole from the ureter. If the stone is large, or if the diameter of the ureter is narrow, the stone will need to be fragmented, which is usually accomplished with a laser. Once the stone is broken into tiny pieces, these pieces are removed.

The passage of the ureteroscope may result in swelling in the ureter. Therefore, it may be necessary to temporarily leave a small tube, called a ureteral stent, inside the ureter temporarily to ensure that the kidney drains urine well.

Ureteroscopy usually can be performed as an outpatient procedure, however; patients may require an overnight hospital stay if the procedure proves lengthy or difficult.

Ureteroscopy (URS) Procedure

Your doctor inserts a funky ureteroscope through the urinary tract opening and into the bladder pretty quickly under anesthesia. Your doctor examines urinary tract including kidneys ureters bladder then locates kidney stone beneath surface tissue and breaks it apart with laser energy.

To help control swelling and allow the kidney to drain urine, your doctor may insert a small plastic tube, called a ureteral stent, in your urinary tract at the end of the procedure. The stent will be removed at a follow-up appointment.

Let your doctor know:

• All of your prescription medicines, vitamins and supplements, herbs and natural remedies, and over-the-counter drugs.
• Any known allergies you have to medicines and the contrast agent used in some X-rays.
• If you may be pregnant.

Preoperative Steps for Ureteroscopy (URS)

1. Imaging & Records:

• Compile all prior imaging (CT scans, X-rays, IVP) and reports for surgeon review.
• Lab tests: Blood work (CBC, metabolic panel), urinalysis, and coagulation profile (PT/PTT).

2. Dietary Restrictions:

• NPO after midnight: No solid food, milk, gum, or candy. Clear liquids may be allowed until 4 hours pre-surgery in some cases.
• Avoid alcohol and smoking on the day of surgery.

3. Medication Adjustments:

• Stop NSAIDs, aspirin, blood thinners (e.g., ibuprofen, Plavix) 2–7 days pre-surgery.
• Continue essential medications (e.g., heart or diabetes drugs) with sips of water up to 4 hours before surgery.

4. Hygiene:

• Preoperative showers: Use antibacterial soap (e.g., Hibiclens) the night before and morning of surgery.
• Do not shave the surgical area

After Ureteroscopy (URS) Surgery

Be aware of these common side effects:

• Nausea and occasional vomiting.
• Pain within the first 24 to 48 hours in your kidneys, abdomen, lower back and sides. Pain may increase when you urinate. Take medicine as prescribed.
• Blood in your urine. The color can range from light pink to reddish and sometimes can even have a brownish hue – but you should be able to see through it. (Medications to help with burning sensation during urination can sometimes turn urine orange or blue.) If bleeding increases significantly, call your doctor immediately or go to an emergency room for evaluation.
• A feeling of fullness and a constant need to urinate (urgency and frequency).
• A burning sensation during urination or when you move.
• Bladder muscle spasms.

Recovery

• The ureteral stent makes it easier to pass stone fragments through the urinary tract and out of your body. However, some fragments may not pass until the stent is removed.
• The stent also helps reduce your risk of serious complications, such as blockage of your urinary tract.
• Your doctor will remove the stent at a follow-up appointment, typically four to seven days after surgery, although sometimes the stent must stay in longer.

Advantages of Ureteroscopy (URS)

Ureteroscopy is a minimally invasive procedure used to diagnose and treat conditions affecting the urinary tract, such as kidney stones and strictures. It offers several benefits compared to other treatment options like open surgery or extracorporeal shock wave lithotripsy (ESWL).

Key Benefits:

✔ Minimally Invasive – No external incisions are required, reducing pain, scarring, and the risk of infection.

✔ Effective for All Stone Types – Unlike ESWL, which works best for softer stones, ureteroscopy can effectively remove or break up all types of kidney and ureteral stones.

✔ High Success Rate – The procedure has a high success rate, especially for stones in the lower and mid-ureter, with a lower chance of needing repeat treatment.

✔ Immediate Stone Removal – Stones can be directly removed using a basket device or broken into smaller fragments with a laser (laser lithotripsy).

✔ Short Recovery Time – Most patients can return home the same day and resume normal activities within a few days.

✔ Suitable for Pregnant Patients and Those on Blood Thinners – Unlike ESWL, ureteroscopy is safe for patients who cannot stop anticoagulants or are pregnant.

✔ Versatile Diagnostic Tool – It allows direct visualization of the ureter and kidney, helping diagnose tumors, strictures, and other abnormalities.