Ureteroscopy (URS) – For Kidney or Upper Ureter Stones

Ureteroscopy (URS) – For Kidney or Upper Ureter Stones

Ureteroscopy (URS) is a minimally invasive procedure used to diagnose and treat stones located in the ureter (tube between kidney and bladder) or within the kidney itself. It is especially useful for medium-sized stones, stones lodged in the upper ureter, or those that haven’t passed naturally.

When is URS Recommended?

URS is ideal for patients who have:

• Stones stuck in the ureter or renal pelvis
• Recurrent pain or infections due to stones
• Failed shock wave lithotripsy (ESWL)
• Narrow ureter or other structural issues preventing stone passage

Procedure Details

1. Anesthesia:
   URS is usually done under general or spinal anesthesia.
2. Scope Insertion:
   A ureteroscope (a thin, lighted tube) is inserted via the urethra → bladder → ureter to reach the stone.
3. Stone Removal or Fragmentation:
   • Small stones are grasped and removed directly.
   • Larger stones are broken into fragments using laser energy (e.g., Holmium laser) — a process called laser lithotripsy.
4. Stent Placement (if needed):
   A temporary stent (a small tube) may be placed in the ureter to allow healing and ease urine flow. It's typically removed after 1–2 weeks.

Advantages of URS

 No incisions or cuts – performed entirely through natural openings
 Quick recovery – most patients go home the same day or next day
 Effective for ureter and kidney stones
 Safe and precise – especially with laser technology
 Low risk of complications
 Suitable for pregnant women or patients who cannot undergo shockwave therapy

Recovery and Aftercare

• Most patients can resume normal activities within 1–2 days.
• Mild burning urination or blood in urine may occur temporarily.
• Stent discomfort (if placed) may include increased frequency or urgency of urination.
• Drink plenty of water and follow the doctor’s advice on pain medications or antibiotics.
• A follow-up visit is usually scheduled within 1–2 weeks.

Risks and Complications

Although URS is generally safe, potential risks include:

• Urinary tract infection (UTI)
• Temporary bleeding
• Injury to the ureter (rare)
• Stent-related discomfort
• Need for repeat procedures in complex cases

FAQs

1. Is URS painful?
The procedure itself is done under anesthesia. Some discomfort or burning may be felt afterward, especially if a stent is placed, but it is manageable with medications.

2. Will I need a hospital stay?
Most patients are discharged the same day or the next day.

3. Is URS better than ESWL (shockwave)?
URS is more effective when stones are larger, harder, or stuck in the ureter or when shockwave therapy has failed.

4. Can I pass stones naturally after URS?
Larger stones are removed or broken during URS, so passing fragments after the procedure is uncommon unless small bits remain.