Ureteroscopy

If you have possible kidney/ureter tumors or dilation, or kidney stones, your health care provider may recommend a ureteroscopy. A ureteroscopy can help diagnose and treat issues in the urinary tract, particularly the kidneys and ureter (the tube that carries urine from the kidneys to the bladder).

Read on to understand more about ureteroscopy and what to expect before, during and after this procedure.

What is a ureteroscopy?

Ureteroscopy is a medical procedure that uses a thin, flexible tube with a light and tiny camera at the end (a ureteroscope) to look inside your bladder and ureter. Urologists perform this procedure under general anesthesia, typically as an outpatient procedure (you go home the same day).

Ureteroscopy is commonly used to diagnose, investigate and treat problems in the urinary tract, like kidney stones. Urologists sometimes perform procedures like removing stones or abnormal growths (polyps) or taking tissue samples (a biopsy) for testing. 

Why may I need a ureteroscopy?

Your provider may recommend this procedure for many reasons, including: 

• Kidney stones: If you have kidney stones that are causing pain, blockages or ongoing urinary tract infections (UTIs), your provider may use a ureteroscope to locate and remove them.
• Urinary blockages: If you have a blockage in your ureter or urinary tract due to scar tissue, polyps or other obstructions, a ureteroscopy may be necessary to clear blockages and restore proper urine flow.
• Blood in urine: If you have unexplained blood in your urine, your provider may use this procedure to find out the cause.
• Abnormal imaging test: If an imaging test such as ultrasound, CT scan or MRI reveals problems in the urinary tract, this test may be necessary to make a diagnosis.
• Diagnostic purposes: If your provider suspects a specific condition, such as cancer or abnormal tissue growth in the urinary tract, they may perform a biopsy to test it. 

Who should get a ureteroscopy?

Ureteroscopy is a safe and effective procedure for individuals of all ages. It is also a safe procedure if you’re pregnant, obese or have a blood clotting disorder. However, it is not a particularly good treatment for very large kidney stones or for individuals who have undergone ureteral or bladder reconstruction.

Possible complications of a ureteroscopy

Ureteroscopies are generally safe procedures, but like any medical treatment they carry potential risks. These risks, though rare, include:

• Bleeding in the urinary tract
• Urine infection like a UTI
• Damage to the urethra or ureter causing scarring (urinary stricture)
• Small tear to the bladder, ureter or urethra
• Reaction to the medication (general anesthesia) that helps you relax and sleep during surgery

If you have any worries or questions about getting a ureteroscopy, it's important to talk to your provider. They’ll help you understand everything and ensure your safety during the procedure.

How to prepare for a ureteroscopy

Your provider will give you specific instructions on how to prepare, but here are a few steps to ensure everything goes smoothly:

• Sign a consent form: You may be asked to sign a form giving your provider permission to perform the procedure. Read the form carefully and ask your provider if anything is unclear.
• Adjust medications: Your provider may ask you to adjust your medications and/or dosage, especially blood thinners, to reduce the risk of bleeding during the procedure. If you have ongoing conditions, such as diabetes or heart disease, your provider will give you specific instructions about your medications.
• Tests: To ensure good health for the procedure, you may need to undergo blood tests, urine tests or imaging scans.
• Make arrangements: Most ureteroscopies are performed in an operating room under general anesthesia. In that case, you will be instructed when to stop eating and drinking. You will also need to have someone take you home afterward.

Let your provider know if you have allergies or reactions to medications, latex or tape and if you are pregnant or think you may be pregnant.

What to expect during a ureteroscopy

How a ureteroscopy is performed may vary depending on your condition and your provider’s practices. 

In general, the medical procedure follows this process:

• You will change into a hospital gown.   
• You may be asked to pee before the procedure.
• You will lie on a bed or table with your head propped up. You’ll likely place your feet in stirrups similar to a pelvic exam.
• You’ll be given either local or general anesthesia to make you comfortable. 
• The ureteroscope is gently inserted through the urethra into the bladder and then further into the ureter.
• Your provider will examine the inside of the urinary tract. If issues are found, surgical instruments can be used to remove kidney stones or take biopsies. These instruments may include a tiny wire basket to grab and pull the stone free, biopsy cup or laser energy to break up larger stones into smaller pieces.
• If any part of the ureter or bladder looks abnormal, your provider may take a biopsy. 
• Your provider may leave a special tube inside your ureter called a stent to help your kidney heal and drain. 
• When the exam is done, the scope will be taken out.

The procedure may take one to two hours, depending on the treatments needed. 

Recovery from a ureteroscopy

After the procedure, you’ll be taken to a recovery area where you’ll rest until the effects of the medicine wear off. You may feel a little groggy or sleepy for a short time. Have someone bring you home after the procedure.

You may be given a prescription medicine (antibiotic) for the first few days after the procedure to prevent an infection. You may experience some discomfort when you pee and see a little blood in your urine for a couple of days. To relieve mild pain, drink plenty of water and take over-the-counter (OTC) or prescribed pain reliever.

If you have a stent, it may cause significant discomfort until shortly after it is removed. You may remove it at home after five to seven days if it has a string, or it will be removed by cystoscopy at a later medical appointment. 

Your provider will provide additional instructions on how to care for yourself after the procedure. 

Call your provider immediately if you have any of the following:

• Fever and chills
• Pain or burning that doesn’t get better after taking pain medicine
• Can’t pee after the procedure
• Symptoms of a UTI
• Stomach pain and nausea

Call 911 or have someone take you to the nearest emergency department if you experience any of the following:

• Sudden chest pain
• Difficulty breathing and swallowing or gasping for air 
• Sudden loss of consciousness

How do I understand my results?

Your provider will discuss the results of your ureteroscopy with you. If problems are found, they will explain what they mean and discuss the next steps, such as further tests or treatments.

Expert care 

Banner Health provides compassionate, expert care to support your health and well-being. Contact Banner Health today if you have questions about ureteroscopy or need to schedule an appointment with a urologist. Our state-of-the-art endoscopy services can help.