What Is Ureteroscopy?

If you have pain when you pee or possibly kidney stones, your doctor may want you to have a ureteroscopy. It’s a procedure to find -- and, in some cases, fix --problems in your urinary tract.

During ureteroscopy, your doctor inserts a thin, flexible scope into your bladder and ureter (the tube that carries urine from your kidneys to your bladder). This way she can look for kidney stones or other signs of trouble.

When Would I Get One?

A ureteroscopy is usually done when you have kidney stones in your ureter.

Kidney stones are pebble-like objects (but not real stones) made of minerals and salts found in urine. They form in a kidney, but can move down the ureter.

A urologist (a doctor who specializes in diseases of the urinary tract) may also recommend a ureteroscopy if she suspects a polyp, tumor or abnormal tissue somewhere in your urinary tract.

The doctor can also use the special scope to remove a stone, polyp, or a piece of tissue (a biopsy) for lab tests.

You may also get other tests if your doctor thinks you may have a urinary tract infection or a related problem. Some of them include:

  • Urine test to diagnose possible infections.
  • CT scan to diagnose kidney stones and identify their size and location.
  • MRI to provide detailed images of your kidneys, bladder, and other internal organs.

Who Needs a Ureteroscopy?

If you have undiagnosed urinary tract problems, such as urine blockage, a ureteroscopy can help identify the problem.

When you see a doctor because it hurts to pee and you’re not going as often as you should, you may or may not need this procedure. It will depend on your symptoms and what other tests show.

Doctors sometimes use ureteroscopy as part of shock wave lithotripsy, a treatment to break up kidney stones. This is most helpful for:

Benefits and Risks

Ureteroscopy is an effective way to do several things. For example, it lets your urologist:

  • Get a very clear view of the urinary tract
  • Remove or break up stones
  • Take out suspicious-looking tissue

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It’s an outpatient procedure, which means you can go home when it’s done.

The potential complications of ureteroscopy include a slight chance of bleeding or injury to the ureter. As with many medical procedures, there is a small chance of infection.

You may have some discomfort afterward when you pee. If you have swelling in the ureter, urinating may be hard for a while.

You will get general anesthesia when you have a ureteroscopy. That means you’re not awake while it happens. As with any procedure using drugs and gases for anesthesia, there is a small chance of other problems.

How Do I Prepare?

You don’t have to do a lot to get ready for a ureteroscopy. You’ll need to pee before the procedure. Your doctor or a nurse will tell you when.

You should also get instructions about how long before the surgery you need to stop eating, drinking and taking some medicines. This is very important if you take blood thinners to reduce your risk of blood clots.

You should also make sure someone can drive you home.

What Happens During a Ureteroscopy?

Once the anesthesia takes effect and you’re asleep, your urologist will insert the tip of the ureteroscope into your urethra (the tube through which urine passes out of your body).

Once the ureteroscope is in the bladder, your urologist releases a sterile solution through the tip of the scope. This fills the bladder so its walls can be seen more clearly. She then gently guides the scope into a ureter. If there is a concern about a kidney, the scope can be moved all the way up into that organ.

It may take up to 30 minutes for her to observe your urinary tract. If a procedure is done to remove or break up a stone, or to take a tissue sample for a biopsy, the ureteroscopy may take longer.

A ureteroscopy that uses a laser to break up small kidney stones may take about 90 minutes. The type of laser used with the ureteroscope is called a “Holmium laser.” A similar procedure uses a tiny basket at the end of the scope to grab and remove a stone.

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After the Procedure

After the ureteroscope is removed and the liquid in your bladder is emptied, you will recover while the anesthesia wears off. That could take 1 to 4 hours. Sometimes a stent (a small tube to offer support) will be left in place, but most often, you don’t get one.

You’ll probably be asked to drink 16 ounces of water an hour during the next 2 hours.

You may have some pain when you pee and see a little blood in your urine for the next 24 hours. After that, there shouldn’t be much pain or discomfort.

You might be prescribed a painkiller and antibiotic just in case of infection. You may also need to take a warm bath or place a warm, damp washcloth over the opening of your urethra to ease some discomfort.

If you have a lot of pain, or chills or fever, tell your doctor. This could mean you have an infection.

Your doctor can clearly see the health of your kidneys and ureters during a ureteroscopy, but if a piece of tissue is removed for a biopsy, you may have to wait a few days for lab results..

WebMD Medical Reference Reviewed by Minesh Khatri, MD on January 16, 2017

Sources

SOURCES:

National Kidney Foundation: “Ureteroscopy.”

Radiopaedia.org, “Ureter.”

National Institute of Diabetes and Digestive and Kidney Diseases: “Cystoscopy and Ureteroscopy.”

Urology Care Foundation: “What are kidney stones?”

Mayo Clinic: “Urinary tract infection: Tests and diagnosis.”

UC San Diego Health: “Ureteroscopy.”

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