Ureteroscopy is a medical procedure where a thin scope is passed through the urethra and bladder and into the ureter to diagnose or treat problems like kidney stones. The doctor can see the inside of the urinary tract and remove stones or take tissue samples. It is a common, minimally invasive procedure with a high success rate for treating stones in the ureter or kidney.
What Exactly Happens During a Ureteroscopy Procedure?
The procedure starts with anesthesia. You will be asleep or numb from the waist down. The doctor then inserts a ureteroscope, which is a long, thin tube with a camera on the end, through your urethra. It passes through the bladder and into the ureter, the tube connecting your kidney to your bladder.
Once the scope reaches the stone or area of concern, the doctor can use small tools passed through the scope. For stones, a laser is often used to break them into smaller pieces. The fragments are then removed with a tiny basket or allowed to pass naturally. The whole procedure usually takes between 30 minutes and two hours.
Most people go home the same day. You will likely have a small tube called a stent placed in the ureter to help it heal and drain urine. The stent is usually removed in a follow-up visit a few days or weeks later. This is a very quick office visit.
What Is the Main Purpose of This Procedure?
The primary purpose of ureteroscopy is to treat kidney stones that are stuck in the ureter. Stones that are too large to pass on their own, usually those over 5 millimeters, are common targets. The American Urological Association recommends ureteroscopy as a first-line treatment for many ureteral stones.
Beyond stones, ureteroscopy is also used for diagnosis. If a patient has blood in their urine or a suspicious growth is seen on imaging, a doctor can use the scope to look directly at the lining of the ureter and kidney. They can take a biopsy of any abnormal tissue to check for cancer.
Another purpose is to treat strictures, which are narrowings of the ureter. The doctor can use a balloon or laser to open the narrowed area. It is also used to remove small tumors in the lining of the urinary tract.
What Are the Real Risks and Side Effects?
Like any medical procedure, ureteroscopy has risks. The most common side effect is blood in the urine. This is normal and usually clears up within a few days. You may also feel a burning sensation when urinating for a day or two.
A more significant risk is infection. Research published in the Journal of Urology shows that the risk of a urinary tract infection after ureteroscopy is around 5-10%. In rare cases, a serious kidney infection can occur. Your doctor will likely prescribe antibiotics before the procedure to lower this risk.
Ureteral injury is another risk. The scope can sometimes damage the lining of the ureter, causing a tear or perforation. This happens in less than 2% of cases. If it occurs, it often heals on its own with a stent left in place for a longer period. Very rarely, surgery is needed to repair the damage.
A less common but important risk is that a stone fragment may not pass and could get stuck again. The success rate for removing all stone fragments in one session is around 80-90% for stones in the lower ureter. For stones higher up or in the kidney, the success rate is slightly lower.
How Does Ureteroscopy Compare to Other Stone Treatments?
There are two main alternatives to ureteroscopy for kidney stones: shock wave lithotripsy (SWL) and percutaneous nephrolithotomy (PCNL). Each has its own strengths and weaknesses. The table below shows a direct comparison.
| Treatment | How It Works | Best For | Recovery |
|---|---|---|---|
| Ureteroscopy | A scope goes up the ureter to remove or laser the stone. | Stones in the ureter or small kidney stones. | 1-2 days. Stent may be needed. |
| Shock Wave Lithotripsy (SWL) | Sound waves from outside the body break the stone. | Smaller stones (under 2 cm) in the kidney. | No incision. Often no stent. Bruising possible. |
| Percutaneous Nephrolithotomy (PCNL) | A small incision in the back to remove large stones directly from the kidney. | Large kidney stones (over 2 cm). | 1-2 days in hospital. Longer recovery. |
Ureteroscopy is often preferred when SWL has failed or is not suitable. It has a higher stone-free rate for stones in the lower ureter compared to SWL. PCNL is reserved for very large or complex stones, as it is more invasive.
Your doctor will choose the best option based on stone size, location, and your overall health. Ureteroscopy is a strong middle ground — more effective than SWL for many stones but less invasive than PCNL.
What Should You Expect Before and After the Procedure?
Before ureteroscopy, you will have blood tests and a urine test to check for infection. You will need to stop eating and drinking for about 8 hours before the procedure. Tell your doctor about all medications you take, especially blood thinners like warfarin or aspirin, as these may need to be stopped temporarily.
After the procedure, you will wake up in a recovery area. You may feel some cramping or a strong urge to urinate from the stent. Drinking plenty of water helps flush out stone fragments and reduces irritation. Your doctor will give you pain medication and possibly antibiotics to take at home.
Most people return to normal activities within 1-2 days. You should avoid heavy lifting and strenuous exercise for about a week. If you have a stent, you may notice blood in your urine when you are active. This is normal. The stent removal is quick and usually causes only mild discomfort.
Call your doctor if you develop a fever over 101°F, severe pain that medication does not help, or if you cannot urinate. These are signs of a possible complication that needs attention.
What Are Common Misconceptions About Ureteroscopy?
One common myth is that ureteroscopy is extremely painful. While you may feel some discomfort after the procedure, the actual procedure is done under anesthesia. You will not feel any pain during it. The post-procedure pain is usually mild and controlled with over-the-counter or prescription medication.
Another misconception is that you will need a long hospital stay. Most ureteroscopies are outpatient procedures. You go home the same day. Only complex cases or patients with complications need to stay overnight.
Some people believe that if you have a stent, you cannot do anything normal. This is not true. You can walk, work at a desk, and do light activities. The stent may cause some bladder irritation or a feeling of needing to urinate often, but it does not stop most daily activities.
A final myth is that ureteroscopy always removes all stone fragments in one go. While success rates are high, sometimes a second procedure is needed. This is more likely with larger or multiple stones. Your doctor will discuss the chance of needing a repeat procedure before you agree to it.
Frequently Asked Questions
How long does ureteroscopy recovery take?
Most people feel back to normal within 1 to 3 days. If a stent is placed, you may feel some irritation until it is removed.
Is ureteroscopy safe for kidney stones?
Yes, it is a standard and safe procedure with a low complication rate. Serious risks like infection or injury occur in less than 5% of cases.
Do you need a stent after ureteroscopy?
Not always, but it is common. A stent helps the ureter heal and prevents swelling. It is usually removed within a week or two.
Can you pass stone fragments after ureteroscopy?
Yes, small fragments that are not removed during the procedure will pass in your urine over the next few days or weeks. Drinking water helps this process.
