Kidney Stone Removal - Ureteroscopy

What are kidney stones?

Kidney stones are hard mineral and salt deposits that form inside your kidneys. They can vary in size and may cause severe pain, blood in your urine, or difficulty passing urine.

What is a ureteroscopy?

Ureteroscopy is a minimally invasive procedure that uses a fine, flexible telescope called a ureteroscope to examine the ureter (the tube that carries urine from the kidney to the bladder) or the kidney itself. This procedure allows the surgeon to locate and remove kidney stones or break them into smaller pieces for easier removal. Ureteroscopy is particularly useful for stones that are too large to pass naturally, cause pain or obstruction, or have not responded to other treatments like shockwave lithotripsy (SWL).

When is a ureteroscopy and stone removal recommended?

Ureteroscopy is often recommended for kidney stones that cause:

• Severe pain (renal colic)
• Persistent urinary tract infections (UTIs)
• Stones that are too large or impacted to pass naturally
• Blockage of urine flow
• Failed treatment with non-invasive methods such as SWL

This procedure is also suitable for stones in complex or narrow areas of the ureter or kidney and for cases where other treatments are not an option.

Preparing for ureteroscopy and stone removal

Before the procedure, you will have a consultation with a urologist to confirm that ureteroscopy is the right treatment for you. The consultation will include imaging tests, such as an ultrasound, X-ray, or CT scan, to determine the size, number, and location of the stones.

In preparation, you may be asked to:

• Stop taking certain medications, such as blood thinners or anti-inflammatory drugs, to reduce the risk of bleeding.
• Fast for several hours before the procedure, particularly if general anaesthesia is being used.

What happens during the procedure?

Ureteroscopy is typically performed under general anaesthesia, so you will be asleep throughout the procedure.

Here’s what to expect:

• A thin, flexible tube (ureteroscope) is inserted through the urethra and bladder into the ureter.
• The ureteroscope, equipped with a camera, allows the surgeon to locate the kidney stone.
• Once located, the stone is either removed with small instruments or broken into smaller pieces using a laser (laser lithotripsy).
• If necessary, a temporary stent may be placed in the ureter to aid urine drainage and help with healing.

The procedure usually takes 30 minutes to 1 hour, depending on the size and number of stones.

What are the benefits of ureteroscopy for stone removal?

• Minimally invasive: No large incisions are required.
• High success rate: Effective for removing stones, even in difficult-to-reach areas.
• Single-session treatment: Often removes stones in one procedure.
• Quick recovery: Most patients return to normal activities within a week.
• Precision: Allows the surgeon to directly visualise and treat the stones.

What are the potential risks and complications?

While ureteroscopy is generally safe, it carries some potential risks, including:

• Temporary bleeding or blood in the urine
• Infection in the urinary tract
• Discomfort during urination
• Injury to the ureter, which may require further treatment
• Stent-related discomfort (if a stent is placed)
• Rarely, narrowing (stricture) of the ureter

Antibiotics may be prescribed to reduce the risk of infection, and your surgeon will discuss these risks with you before the procedure.

Recovery after ureteroscopy

Most patients recover quickly after ureteroscopy. Here’s what to expect:

• Short-term effects: You may experience mild discomfort, blood in your urine, or a burning sensation when urinating for a few days.
• Activity: Avoid heavy lifting, strenuous activities, and sexual activity for 1 to 2 weeks. Light walking is encouraged to aid recovery.
• Pain management: Take prescribed pain relief to manage discomfort.
• Hydration: Drink plenty of water to flush out any remaining stone fragments.

If a stent was placed, it is usually removed during a follow-up appointment within a few weeks.

Long-term outcomes

Ureteroscopy is highly effective at removing kidney stones, particularly those located in the ureter or hard-to-reach areas of the kidney. Most patients experience relief from symptoms within days of the procedure.

To prevent future kidney stones:

• Drink plenty of water to stay hydrated.
• Reduce salt and oxalate-rich foods (like spinach and nuts) in your diet.
• Follow any specific dietary or medication advice provided by your doctor.

While recurrence of kidney stones is rare after ureteroscopy, your urologist will monitor your recovery and provide recommendations to minimise the risk of future stones.

Ureteroscopy offers a precise and effective solution for managing kidney stones, helping you return to a pain-free and active lifestyle.