Ureteroscopic stone removal

What is this?

Telescopic removal/ fragmentation of stone(s) in the ureter or kidney with possible placement of a soft plastic tube or stent between the kidney and the bladder. This procedure also includes cystoscopy and x-ray screening

What alternatives are there?

Open surgery, shock wave therapy or observation to allow spontaneous passage

What to expect before procedure

You will usually be admitted on the same day as your surgery. You will normally receive an appointment for pre-assessment, approximately 14 days before your admission, to assess your general fitness, to screen for the carriage of MRSA and to perform some baseline investigations. After admission, you will be seen by members of the medical team which may include the Consultant, Specialist Registrar, House Officer and your named nurse. An X-ray may be taken in advance of surgery to confirm the position of your stone(s). You will be asked not to eat or drink for 6 hours before surgery and, immediately before the operation, you may be given a pre-medication by the anaesthetist which will make you dry-mouthed and pleasantly sleepy.

What happens during the procedure?

Normally, a full general anaesthetic will be used and you will be asleep throughout the procedure. You will usually be given injectable antibiotics before the procedure, after checking for any allergies. A telescope is inserted into the bladder through the water pipe (urethra). Under X-ray screening, a flexible guidewire is inserted into the affected ureter up to the kidney. A longer telescope (either rigid or flexible) is then inserted into the ureter and passed up to the kidney. The stone is disintegrated using a mechanical probe or laser and the fragments extracted with special retrieval devices. A ureteric stent is normally left in place, together with a bladder catheter, after the procedure.

After the procedure

If a bladder catheter has been inserted, this is usually removed on the day after surgery. You will be able to go home once you are passing urine normally. An X-ray is often performed the day after surgery to check on the presence of residual stone fragments. The average hospital stay is 1 day.

Potential side effects