Ureteroscopy with Laser Lithotripsy

What is ureteroscopy?

A thin scope is passed through the urethra and bladder up the ureter to the stone. A laser fiber fragments the stone and a basket removes the pieces. No incisions are made.

Who may benefit?

• Patients with stones in the ureter causing pain or obstruction.
• Patients with kidney stones that are too large to pass or have failed to pass.
• Patients on blood thinners, in whom shock wave therapy may be unsafe.
• Patients who need a definitive answer in one procedure.

How is the procedure performed?

Under general anesthesia, usually taking 30 to 90 minutes. A temporary stent is often placed afterward to keep the ureter open while swelling settles. Most patients go home the same day.

What are the benefits?

• High stone-free rates in a single procedure.
• No incisions and rapid return to activity.
• Stone fragments can be analyzed to guide prevention.

What are the alternatives?

Observation with medical expulsive therapy for small stones, shock wave lithotripsy, or percutaneous nephrolithotomy for large stone volumes.

What are the risks?

• Stent discomfort, urgency, and blood in the urine while the stent is in.
• Urinary tract infection.
• Ureteral injury or narrowing, which is uncommon.
• Residual fragments requiring a second procedure.

What should I expect before surgery?

• A pre-operative visit to review your history, medications, and goals.
• Instructions on blood thinners, supplements, and diabetes medications.
• A urine culture so any infection is treated before the procedure.
• Nothing to eat or drink after midnight unless told otherwise.
• A responsible adult to drive you home on the day of surgery.

Will I have a stent?

Often yes. Stents are typically removed in the office within three to ten days, sometimes by a string left in place that you or the office can remove.

What should I expect during recovery?

• Burning, urgency, and pink urine for several days, especially with a stent.
• Flank discomfort while urinating is normal with a stent in place.
• Most patients return to work within a few days.
• Increase fluids and collect fragments for analysis if instructed.

When should I call the office?

• Fever above 101.5°F or shaking chills.
• Inability to urinate, or a catheter that stops draining.
• Heavy bleeding, or clots that do not clear with increased fluids.
• Pain that is not controlled by your prescribed medication.
• Redness, swelling, or drainage at an incision site.