Definition

Ureteroscopy uses a small lighted viewing scope to examine the ureters. Ureters are the tubes that connect the kidneys to the bladder. This procedure can help diagnose and treat problems in the urinary tract, such as kidney stones.

Alternative Names

Ureteral stone surgery; Kidney stone - ureteroscopy; Ureteral stone removal - ureteroscopy; Calculi - ureteroscopy

Description

Ureteroscopy is performed with a ureteroscope. This is a small tube (rigid or flexible) with a tiny light and camera on the end.

• The procedure usually takes 1 hour.
• You are given general anesthesia. This is medicine that allows you to sleep.
• Your groin and urethra are cleaned. The scope is then inserted through the urethra, into the bladder, and then up into the ureter.

The next steps are described below.

Why the Procedure Is Performed

During the procedure, your surgeon (urologist) may:

• Use small instruments that are sent through the scope to grab and remove kidney stones or break them up using a laser.
• Place a stent in the ureter to allow urine and small pieces of kidney stone to pass through. If you have a stent, you will need to return to have it removed in 1 or 2 weeks. This can usually be done in the surgeon's office without anesthesia.
• Check for cancer.
• Examine or remove a growth or tumor.
• Examine areas of the ureters that have become narrow.
• Diagnose repeated urinary tract infections and other problems.

Risks

Risks for surgery and anesthesia in general are:

• Problems breathing
• Reaction to medicines
• Bleeding, blood clots, infection

Risks for this procedure include:

• Injury of the ureter or kidney
• Urinary tract infection
• Narrowing or scarring of the ureter

Before the Procedure

Tell your surgeon what medicines you are taking, including ones you bought without a prescription. Also tell your surgeon if you are pregnant or think you may be.

Arrange to have someone take you home after the procedure.

Follow instructions about how to prepare for the procedure. These may include:

• Not eating or drinking anything after the midnight prior to your procedure.
• Temporarily stopping certain medicines, such as aspirin or other blood thinners. Do not stop taking any prescription medicines unless your surgeon tells you to stop.
• Ask your surgeon which medicines you should still take on the day of your surgery.

After the Procedure

You will wake up in a recovery room. You can go home once you are awake and can urinate.

At home, follow any instructions you're given. These may include the following:

• You will need to rest for 24 hours. You should have someone stay with you during that time.
• Your surgeon will likely prescribe medicines for you to take at home. This may include a pain medicine and an antibiotic to prevent infection. Take these as instructed.
• Drink 4 to 6 glasses of water a day to dilute your urine and help flush out your urinary tract.
• You will see blood in your urine for several days. This is normal.
• You may feel pain in your bladder and burning when you urinate. If your surgeon says it's OK, sitting in a warm bath may help relieve the discomfort. Using a heating pad set on low can also help.
• If your surgeon placed a stent, you may feel pain in your side, especially during and right after urination.
• You can drive after you've stopped taking any narcotic pain relievers.

You will likely feel better in about 5 to 7 days. If you have a stent, it may take longer to feel like yourself again.

Outlook (Prognosis)

Treating kidney stones using ureteroscopy usually has a good outcome.

References

Chew BH, Harriman DI. Ureteroscopic instrumentation. In: Smith JA Jr, Howards SS, Preminger GM, Dmochowski RR, eds. Hinman's Atlas of Urologic Surgery. 4th ed. Philadelphia, PA: Elsevier; 2019:chap 40.

Duty BD, Conlin MJ. Principles of urologic endoscopy. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 13.