What is ureteroscopy?

A ureteroscopy is a type of procedure. Your doctor may do it to remove kidney stones from one of your ureters. These are the tubes that carry urine from your kidneys to your bladder. Your doctor may also do it to help find the reason for a urinary infection or blood in your urine.

Your doctor puts a thin scope with very small tools in it into your urethra. This is the tube that carries urine from your bladder to the outside of your body. Then the doctor moves the scope through your urethra and bladder into your ureter.

The doctor may use a wire with a tiny basket on the end to take out a kidney stone. Or the doctor may use a laser to break up a stone. If this is done, the pieces will wash out of your body in your urine.

You may be awake during the procedure. Or you may have medicine to make you sleep. In either case, you will not feel pain.

Activity

• You can go back to work and other activities the next day.

Diet

• Try to drink two 8-ounce glasses of water each hour for 2 hours after the procedure. This may help ease the burning when you urinate.

Medicines

• Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• If you take medicine to stop the burning when you urinate, take it exactly as recommended. Be safe with medicines. Call your doctor if you think you are having a problem with your medicine. You will get more details on the specific medicine your doctor recommends.
• If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
• Ask your doctor if you can take an over-the-counter pain medicine, such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). Read and follow all instructions on the label. Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.

Heat

• Take a warm bath. This may soothe the burning.
• You also can hold a warm washcloth over your urethra for comfort. (The urethra is where your urine comes out.)

Procedures can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for your procedure.

Preparing for the procedure

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what procedure is planned, along with the risks, benefits, and other options.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your procedure. Your doctor will tell you if you should stop taking any of them before the procedure and how soon to do it.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your procedure. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

Complications are more likely when the stone is close to the kidney (upper third of the ureter) and include:

• Injury to the ureter.
• Urinary tract infection.
• Bleeding.
• Abdominal (belly) pain.

Most people are able to go home the same day of the procedure. But you may need to stay in the hospital. If you do, the stay is usually no more than 24 to 48 hours.

For several hours after the procedure you may have a burning feeling when you urinate. This feeling should go away within a day. Drinking a lot of water can help. Your doctor also may advise you to take medicine that numbs the burning. This medicine is called phenazopyridine. It is available by prescription and over the counter. Brand names include Pyridium and Uristat.

You may have some blood in your urine for 2 or 3 days.

Your doctor may prescribe an antibiotic for a day or two. This will help prevent an infection.

Urologists use ureteroscopy to remove stones that are stuck in the ureter and are closer to the bladder than the kidney (in the lower third of the ureter). But newer technology is allowing ureteroscopy to be used even for small stones in or near the kidney.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your procedure may be canceled. If your doctor told you to take your medicines on the day of the procedure, take them with only a sip of water.
• Take a bath or shower before you come in for your procedure. Do not apply lotions, perfumes, deodorants, or nail polish.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• You may need to give a urine sample. This is to make sure you don't have an infection.
• Before the procedure, a health professional will clean the area around your urethra. He or she will also put numbing gel inside your urethra.
• You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.