For this procedure the surgeon, often a urologist, doesn't make any incisions (cuts in the body). He or she first inserts a thin viewing instrument (ureteroscope) into the urethra (the tube that leads from the outside of the body to the bladder). Then the doctor passes the ureteroscope through the bladder and the ureter, to get to where the kidney stone is located.
See a picture of ureteroscopy.
- The urologist removes the kidney stone with forceps or by using an instrument with a "basket" that grabs the stone.
- Smaller stones can be removed all in one piece. Larger stones may need to be broken up before they can be removed.
- Several types of instruments are available to break up stones. But most urologists prefer to use a laser.
The urologist can also use the ureteroscope to reach a kidney stone that is stuck in the ureter just after it leaves the kidney. He or she may then try to push the stone back up into the kidney. After the stone is back in the kidney, the stone may be broken up using lithotripsy.
What To Expect
Most people are able to go home the same day of the procedure. But you may need to stay in the hospital. If you do, the stay is usually no more than 24 to 48 hours.
For several hours after the procedure you may have a burning feeling when you urinate. This feeling should go away within a day. Drinking a lot of water can help reduce the burning. Your doctor also may recommend you take medicine to numb the burning.
You may have some blood in your urine for 2 or 3 days.
Why It Is Done
Urologists use ureteroscopy to remove stones that are stuck in the ureter and are closer to the bladder than the kidney (in the lower third of the ureter). But newer technology is allowing ureteroscopy to be used even for small stones in or near the kidney.
Complications are more likely when the stone is close to the kidney (upper third of the ureter) and include:
- Injury to the ureter.
- Urinary tract infection.
- Abdominal (belly) pain.
What To Think About
Ureteroscopy may be more difficult, or not possible, if you have had surgery on the abdomen or pelvis, an injury to the ureter, or an enlarged prostate.