UC San Diego Health's
Comprehensive Kidney Stone Center offers ureteroscopy, a minimally invasive surgical technique to remove kidney stones that have moved from the kidney to the ureter.
A doctor passes tiny scopes (the size of a large spaghetti nooed) through the urethra and up the urinary collecting system to identify and reach the kidney stone. An even-smaller fiber-optic laser is then passed through the working channel and camera of the ureteroscope so that the surgeon can see and remove or break up the stone. Holmium laser (Ho:YAG) is the most common and efficient laser for stone disintegration. The procedure is typically an outpatient procedure.
Ureteroscopy is just one of the
treatments for kidney stones, typically used when the stone is less than 1.5 cm and located in either the kidney or anywhere in the ureter.
What to Expect From Ureteroscopy
The ureteroscopic stone removal procedure is done under general anesthesia and takes approximately 1.5 hours with subsequent post-operative recovery. Sometimes, a hollow tube called a ureteral stent is used to prevent post-operative flank pain (that can mimic kidney stone pain). The stent is placed in the ureter for a short time to keep it open and drain urine and any small stone pieces.
You can go home the same day and return to the clinic after four to seven days for stent removal. The stent will either be removed with a tiny flexible scope passed through the meatus, performed in the clinic office (require a few minutes to perform). Alternatively, the stent is removed by pulling a string attached to the stent.
Post-operative pain can vary and oral medications will be given before your discharge. Passage of sand-like particles is common as the minuscule stone fragments will pass over the eight weeks of postoperative recovery. You can usually return to work after the stent is removed.
You will then return to the clinic after eight weeks. By then, you will need to have completed:
- A 24-hour urine collection. This collection should be done about four weeks after the surgery.
- An ultrasound of the kidney six weeks after surgery to ensure the kidney has healed from the surgery.
Stone-free rates after a ureteroscopy depend on the location of the kidney stone in your body. Stones in the distal ureter have a 99 percent success rate while stones in the proximal ureter have success rates ranging from 70 percent to 90 percent. Stone-free rates for stones located in the kidney itself are approximately 80 percent to 90 percent.
Ureteroscopy is a very common and safe outpatient procedure. Nevertheless, complications can happen, including infection, ureteral stricture (1 percent), need for percutaneous tube placement (rare), open conversion (very rare) bleeding, need for transfusion (less than 1 percent) and risk of additional procedures to completely remove kidney stones.