Ureteroscopic Stone Removal

If the kidney stone has moved from the kidneys down into the ureter, the tube that carries urine from the kidney to the bladder, ureteroscopy can be used to remove it. A urologist can use either extracorporeal shock wave lithotripsy or ureteroscopy to remove stones from the ureter. The technique chosen depends on the type of ESWL machine available and the preference and skills of the urologist.

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A ureteroscope is a small, flexible telescope that is used to examine and perform procedures on the ureter. A ureteroscope enters the body through the urethra, following it into and then through the bladder to reach the ureter. A ureteroscope is equipped with fiber-optic lights and small working channels through which devices can be passed to break up the kidney stone, snare it, and remove it. If the stone is large, the urologist may use ultrasound, laser, or a technique called electrohydraulic lithotripsy to shatter the stone prior to removal. After the procedure, a small stent (tube) may be inserted in the ureter for a few days to minimize swelling and promote healing.

Typically the procedure is performed on an outpatient basis with most people returning to work within a few days. Although an incision is not needed, most patients undergoing this procedure receive local or general anesthesia. Preparing for anesthesia may involve abstaining from food and beverages prior to the exam; check with your healthcare provider for exact restrictions.

Ureteroscopy is not without risk; potential complications are perforating the ureter or causing scar tissue to develop. The risk of complication increases if the stone has been embedded in the wall of the ureter for more than two months.