A thin lighted tube equipped with a camera, called an ureteroscope, is passed through the urethra and bladder and into the ureter and kidney.
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, is 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 visualised during stone treatment, the stone fragmentation and clearance rate is very high.
Ureteroscopy is performed though the urethra and no incision is required. Recovery from surgery is quick, and this operation is usually be performed as day surgery. A general anaesthetic 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 removed 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.
Most patient will notice some pain and blood in the urine after the operation for a few days. Stent symptoms will persist until the stents removed. Most patients can expect to return to full activity one week after surgery.