Ureteroscopy (URS)

Your doctor may recommend URS surgery if you have a large stone in your kidney or ureter. The surgery typically takes 30 minutes to two hours and can be done as an outpatient procedure. You should be able to resume normal activities in two to three days.

The Procedure

Ureteroscopy
(URS)

After you are under anesthesia, your doctor inserts a telescope-like instrument, called a ureteroscope, through the opening of your urinary tract and into the bladder, which means there are no surgical cuts or incisions made. Your doctor uses the scope to examine your urinary tract – including your kidneys, ureters and bladder – then locates the kidney stone and breaks it apart using laser energy or removes the stone with a basket-like device.

To help control swelling and allow the kidney to drain urine, your doctor may insert a small plastic tube, called a ureteral stent, in your urinary tract at the end of the procedure. The stent will be removed at a follow-up appointment.

Before Surgery

Let your doctor know:

All of your prescription medicines, vitamins and supplements, herbs and natural remedies, and over-the-counter drugs.
Any known allergies you have to medicines and the contrast agent used in some X-rays.
If you may be pregnant.

Review the pre-operative directions provided by your doctor. You may need to:

Schedule appointments for an electrocardiogram (EKG), X-rays, or blood and urine tests.
Discuss with your doctor medicines that might increase your risk of bleeding, such as aspirin, ibuprofen, warfarin, clopidogrel and non-steroidal anti-inflammatory drugs. You may need to stop taking some of these medicines before the procedure.
Take antibiotics, if prescribed, to help prevent infection.
Check with your doctor on which of your regular medicines to take the morning of surgery. On that day, take these medicines with only a small sip of water.
Have nothing to eat or drink after midnight the night before surgery (except the sip of water with your morning medicines).

Arrange for a ride home

You cannot drive yourself home after surgery, so ask a family member or trusted friend to pick you up. Most hospitals and surgery centers will not allow you to take a taxi home after surgery.

After Surgery

Be aware of these common side effects:

Nausea and occasional vomiting.
Pain within the first 24 to 48 hours in your kidneys, abdomen, lower back and sides. Pain may increase when you urinate. Take medicine as prescribed.
Blood in your urine. The color can range from light pink to reddish and sometimes can even have a brownish hue – but you should be able to see through it. (Medications to help with burning sensation during urination can sometimes turn urine orange or blue.) If bleeding increases significantly, call your doctor immediately or go to an emergency room for evaluation.
A feeling of fullness and a constant need to urinate (urgency and frequency).
A burning sensation during urination or when you move.
Bladder muscle spasms.

If you go home with a ureteral stent:

The ureteral stent makes it easier to pass stone fragments through the urinary tract and out of your body. However, some fragments may not pass until the stent is removed.
The stent also helps reduce your risk of serious complications, such as blockage of your urinary tract.
Your doctor will remove the stent at a follow-up appointment, typically four to seven days after surgery, although sometimes the stent must stay in longer.