Ureteroscopy is a type of treatment which is done with a small-calibre endoscope. URS is common, success rates are very high, and the risk of complications is low. For URS you will receive general or local anaesthesia. Once you are under anaesthesia, the doctor enters your bladder with the endoscope through the urethra without making an incision in your body. The stone is pulled out using a special “basket” (Fig. 1).
How is URS performed?
For URS you will receive general, spinal, or intravenous anaesthesia. Once you are under anaesthesia, the doctor enters your bladder with the endoscope through the urethra without making an incision in your body. Depending on the location of the stone, a rigid or a flexible ureteroscope is used. A flexible ureteroscope allows your doctor to reach virtually every point within the kidney (Fig. 2).
When the stone is identified, it is pulled out using a special “basket”. If the stone is too big to be removed completely, it can be fragmented using laser, ultrasound, or a pneumatic lithotripter (which works like a little jackhammer). At this point all stone fragments are removed.
Based on how the operation goes, your doctor may need to place a JJ-stent in the ureter to make sure urine can flow through the urinary system. The stent will be removed when your urine flow is back to normal. This can take anywhere between several days and a few weeks.
When should I consider URS?
If your stone is not large (generally under 2 centimetres), URS is an alternative to SWL. Although URS is more invasive than SWL and requires anaesthesia, it is a safe and effective treatment option for kidney or ureteral stones. Because the stone fragments are removed during the procedure, you don’t have to pass them afterwards. You have a high chance of being stone-free with a single operation. Your doctor will discuss the differences between SWL and URS in your individual situation.
When is URS not recommended?
There are few contraindications for URS. In general it can be performed in almost every patient, as long as your condition allows anaesthesia and you do not have an untreated urinary tract infection. URS can even be done without stopping medication for blood clotting. However, it is always important to discuss your individual situation with the doctor.
How do I prepare for the procedure?
Your doctor will advise you in detail how to prepare for the operation. You must not eat, drink, or smoke for 6-8 hours before the procedure to prepare for the anaesthesia.
How long will it take me to get back to my normal daily activities?
Usually you can leave the hospital 2 days after the procedure and return to your normal daily activities. Your urine can contain some blood for a couple of days. If a JJ-stent was placed during the procedure, your doctor will take it out when your urine flow is back to normal.
You need to go back to the hospital right away if you:
- Develop a fever
- Feel pain in your kidney or flank
Advantages of URS
Disadvantages of URS