Ureteroscopy

What is ureteroscopy?

Ureteroscopy is an outpatient procedure most commonly done to treat stones in the ureters (the tubes that connect your bladder to your kidneys) or kidney. It may also be used to evaluate and treat other causes of kidney blockage or blood in your urine.

Ureteroscopy is done with an ureteroscope, a long, thin tube that has an eyepiece on one end and a tiny lens and a light on the other end. In general, there are two ways to perform ureteroscopy for stones:

• If the stone is small, your healthcare provider will insert a scope into the ureter to remove the stone. The type of scope used in this procedure will have a small basket at the end of a wire that is run through an extra channel in the ureteroscope. The basket is used to collect the stone.
• In cases when the stone is larger, your healthcare provider will extend a flexible fiber through the scope up to the stone. With a laser beam shining through the scope, the healthcare provider will break the stone into pieces small enough to be passed out of the body with urine.

Based on the location, size, and what the stone is made of, your healthcare provider will determine the best ureteroscopy treatment option for you.

Why do I need to have ureteroscopy?

Your healthcare provider may suggest ureteroscopy if you have one or more of the following conditions:

• Blood in the urine.
• Blockage of the ureter and/or kidney (from stones and tumors).

Am I a good candidate for ureteroscopy?

If you have a ureteral stone close to the bladder, especially in the lower half of your ureter, then ureteroscopy is the most effective type of treatment. Ureteroscopy is also a good option if you're pregnant, have obesity or have a blood clotting disorder.

How should I prepare for ureteroscopy?

Ask your healthcare physician if there are special instructions to prepare for ureteroscopy. For the most part, patients are told not to eat before the procedure.

You may be asked to give a urine sample before the procedure to check for infection. If so, you may be instructed not to urinate for an hour before the procedure.

What happens during ureteroscopy?

You will be asleep for this surgery. Your healthcare provider will insert the ureteroscope into your bladder and ureter to look for problems in the urinary tract.

What should I expect after ureteroscopy?

Since you will have a general anesthetic during the procedure, you should arrange for a ride home.

For the first two days after the procedure, your healthcare provider may prescribe an antibiotic medication to prevent an infection. Signs of infection include fever, chills and worsening pain. Tell your healthcare provider if you notice any of those signs.

Most ureteroscopy patients have mild to moderate pain that can be managed with medications. To relieve mild pain:

• You should drink two eight-ounce glasses of water every hour in the two hours after the procedure.
• With your healthcare provider’s permission, you may take a warm bath to relieve the pain.
• You can apply a warm, damp washcloth over the urethral opening.
• Ice packs or heating pads for the kidney may help with the pain.

Other side effects include cramps in the kidney and bladder or burning with urination. Urine may look pink or red (which is a sign to drink more fluids). These symptoms may last until the stent is removed.

What are the risks of ureteroscopy?

The risks of ureteroscopy treatment include infection, bleeding and injury to the ureter. There is a one in 1000 risk of a major injury that could require an extensive surgery to repair. Your healthcare provider may need to use a stent (small tube) and leave it in place for one to two weeks to help your kidney heal and drain. If you have a stent, an appointment will be made to have it removed.