Ureteroscopy

The surgeon, often a urologist, doesn't make any incisions (cuts in the body) for this procedure. 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.

Both rigid and flexible ureteroscopes are effective in stone removal.

Ureteroscopy is an outpatient procedure. Most people are able to go home the same day of the procedure. You may need to stay in the hospital. If you do, the stay is usually no more than 24 to 48 hours.

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.

Ureteroscopy is successful in more than 95 out of 100 people.¹

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.
• Bleeding.
• Abdominal pain.

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.

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Citations

1. Spector DA (2007). Urinary stones. In NH Fiebach et al., eds., Principles of Ambulatory Medicine, 7th ed., pp. 754–766. Philadelphia: Lippincott Williams and Wilkins.