What is the Ureteroscopy Procedure?

Ureteroscopy is an outpatient procedure used for diagnosing and treating various problems in the urinary tract, such as ureteral stones. Your doctor inserts a small, flexible scope into your bladder and ureter to examine the stones. Then, a basket-like device is used to remove the stones from your body. During ureteroscopy surgery, your doctor may place a stent to hold open your ureter.

Advantages of Ureteroscopy

There are several advantages of ureteroscopy.

Advantages include:

• Ureteroscopy can treat stones not seen by imaging tests.
• Ureteroscopy can treat stones anywhere in your ureter or kidney.
• Ureteroscopy can treat patients who are pregnant, who cannot be treated with other procedures or who can not stop blood thinner medication.

Who is a Good Candidate for this Treatment?

Your doctor may recommend ureteroscopy surgery if you meet certain characteristics of a good candidate for the procedure.

Characteristics of a good candidate include:

• Kidney stones
• Kidney tumor
• Ureter tumor
• Kidney stone
• Ureter stone
• Blood in urine
• Pregnant
• Obese
• Blood clotting condition

Ureteroscopy is recognized as an effective treatment for ureter stones in the bottom half of your ureter.

Who is Not a Good Candidate for this Treatment?

In some circumstances, your doctor may recommend treatments other than ureteroscopy. Treatments such as percutaneous nephrolithotomy or open surgery may prove more effective.

Reasons for other treatments include:

• Previous urinary tract surgery — Urinary tract reconstruction may have reshaped your anatomy, preventing the passage of a ureteroscope.
• Large stones — If you have a large, irregular, or extremely hard stone, your doctor may recommend other treatments besides ureteroscopy.

Potential Risks

There are potential risks with ureteroscopy. Your doctor will discuss these risks with you prior to your procedure.

Possible risks:

• Bleeding — There is a low risk of bleeding after the surgery.
• Infection — Any surgical procedures might lead to infection. Your doctor will likely prescribe antibiotics to help prevent infection.
• Injury — There is a risk of damage to your ureter. In very rare cases, serious injury might require additional surgery to repair the damage.

How to Prepare

Your doctor will help you prepare for your ureteroscopy procedure.

Common preparations include:

• Diet — Your doctor will likely advise you what to eat and drink in the 24 hours leading up to your procedure.
• Medications — Your doctor may ask you to stop certain medications. For example, it is common for doctors to ask patients to avoid blood thinners before the surgery.
• Transportation — Your doctor will likely ask you to arrange transportation back home after your procedure.
• Urine sample — Your doctor may ask you for a urine sample before the surgery.

What to Expect During the Procedure

Ureteroscopy surgery is usually performed in a hospital or medical facility as an outpatient procedure. If you stay overnight in the hospital, you will most likely be released in 24-48 hours. You can expect the surgery to last for approximately 1.5 hours.

You will receive anesthesia before your procedure. Therefore, during the surgery, you will be asleep. Your doctor will insert the ureteroscope into your ureter to examine and remove any blockages, such as stones.

If the stones are large, your doctor may use a laser to divide the stones into smaller fragments. Then, your doctor will use a medical basket to remove the fragments. Sometimes, a stent is placed in your ureter to hold the passage open for the surgery.

What to Expect After the Procedure

After your surgery, you will be moved to a recovery room. Your doctor may release you the same day or ask you to stay overnight in the hospital for monitoring.

You might experience:

• Pink or reddish urine
• Painful urination
• Kidney cramps
• Bladder cramps

Your doctor may prescribe pain medication for your discomfort, antibiotics to prevent infection, and ask you to drink more water while you recover. If your doctor orders a biopsy of any tissue removed during surgery, you will usually get the results in a few days.

If you or a loved one want more information about ureteroscopy, a urologist at Baptist Health may be able to help.