Ureteroscopy

Ureteroscopy uses a small lighted tube 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

Description

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

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

The next steps are described below.

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Why the Procedure Is Performed

During the procedure, your doctor 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.
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 of surgery and anesthesia in general are:

Problems breathing
Reaction to medicines
Bleeding, blood clots, infection

Risks of this procedure include:

Injury of the ureter or kidney
Urinary tract infection

Before the Procedure

Tell your health care provider what medicines you are taking, including ones you bought without a prescription.

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 doctor tells you to stop.
Ask your doctor which drugs 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, you will need to rest for 24 hours. You should have someone stay with you during that time.
Your doctor 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 doctor 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 doctor 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

Duffey B, Manoj M. Principles of endoscopy. In: Wein, AJ, Kavoussi, LR, Novick, AC, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 8.

Haleblian GE. Ureteroscopic instrumentation. In: Smith JA, Howards SS, Preminger GM, eds. Hinman's Atlas of Urologic Surgery. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 120.

Matlaga B, Lingeman J. Surgical management of upper urinary tract calculi. In: Wein, AJ, Kavoussi, LR, Novick, AC, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 48.