Ureteroscopy and Laser

Ureteroscopy involves passing a thin telescope through the natural water passage (i.e. through the urethra and bladder), up the ureter to the stone. For stones in the ureter (pipe from kidney to bladder), this is often a metal telescope called semi-rigid or rigid ureteroscope. This however turn corners to access the different parts of the kidney. So for this a bendy telescope - a flexible ureteroscope is used.

Over the past 20-30 years, the technology has advanced significantly, making this an excellent choice for stones up to 2cm (sometimes bigger) anywhere in the kidney or ureter. It is however invasive and requires an anaesthetic (usually general anaesthetic but can be done with spinal anaesthetic). Once the stone is seen a very fine laser fibre (approx. diameter 0.25mm) is passed down the ureteroscope and the holmium laser used to precisely fragment the stone under vision. Fragments may be lased to dust and some fragments may be retrieved using a specialised basket. This allows stone to be sent for analysis.

The procedure is often performed as a day case but sometimes a 1 night stay may be requried. It is commom for a JJ stent to be left in the kidney afterwards. This is like a long thin straw running from the kidney to the bladder. It helps to drain the kidney, prevents blockage from swelling or stone fragments and widens the ureter, so once it is removed, residual tiny fragments can easily pass.