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Ureteroscopy with Laser Lithotripsy

What is Ureteroscopy?

Ureteroscopy is a procedure that involves the use of a thin, long tube called a ureteroscope, to examine, diagnose and treat urinary tract problems. The ureteroscope is most commonly used for the diagnosis and treatment of kidney stones but is also indicated for the treatment of various conditions such as frequent urinary tract infections, urinary blockage, hematuria (blood in the urine), unusual cell growth or tumor in the ureters (urine tubes). Ureteroscopy may be flexible, or rigid and firm.

Laser Lithotripsy

The lower half of the kidney can be accessed with a rigid ureteroscope and the kidney can be accessed with a flexible ureteroscope.

Once the stone is located with the ureteroscope, instruments can be passed through the scope to treat the stone. Very thin laser fibers, diameter ranging from 0.2 to 0.4mm, are used to treat the stone and break it down into very fine fragments of less than 1 mm. These fragments are then flushed out. Alternatively, a basket can be used to grasp the stones and allow the stones to be pulled out. This is only used for small stones to avoid damage to the ureter.

Because the stone is directly visualized during stone treatment, the stone fragmentation and clearance rate is very high. Ureteroscopy is performed through the urethra and no incision is required. Recovery from surgery is quick, and this operation is usually performed as day surgery. A general anesthetic is required.

The stone can be treated in one session most of the times, sometimes, if the ureter is swollen or if the stone is large, more than one session may be required to completely remove the stone. A stent is usually left in the ureter for one week following ureteroscopy to facilitate drainage of urine and passage of fragments. Without a stent, swelling of the ureter after ureteroscopy can cause obstruction and pain.

After the Procedure

Most patients will notice some pain and blood in the urine after the operation for a few days. Stent symptoms will persist until the stents are removed. Most patients can expect to return to full activity one week after surgery.

American College of Obstetricians and Gynecologists American College of Surgeons American Board of Obstetrics and Gynecology