Kidney Stone Treatment
Ureteroscopy
When a stone needs to be dealt with definitively, ureteroscopy reaches it directly — a thin scope passed up through the urinary tract to the stone, which is then broken apart with a laser and removed. There are no incisions anywhere on the body, and unlike treatments that rely on fragments passing over weeks, the stone is generally gone when you wake up. Texas Regional Urology's board-certified urologists perform ureteroscopy with evaluation and follow-up at our offices in The Woodlands, Tomball, and Kingwood.
Reaching the Stone Directly
What Is Ureteroscopy?
Ureteroscopy uses the urinary tract as its own access route. A thin, flexible or rigid scope is passed through the urethra, into the bladder, and up the ureter to the stone. The surgeon sees the stone directly on a monitor.
A laser fiber passed through the scope then fragments the stone — most commonly a holmium laser, which breaks stones of essentially any composition, including the hard ones that resist shock wave lithotripsy. Fragments are either removed with a small basket or reduced to dust fine enough to pass without notice.
Because the stone is addressed directly rather than fragmented and left to clear, single-session success rates are high. The trade-offs are that a scope must traverse the ureter, and a temporary stent is usually left in place afterward to prevent swelling from obstructing the kidney. That stent is the part most patients remember. Learn more about kidney stones.
A laser fiber passed through the scope then fragments the stone — most commonly a holmium laser, which breaks stones of essentially any composition, including the hard ones that resist shock wave lithotripsy. Fragments are either removed with a small basket or reduced to dust fine enough to pass without notice.
Because the stone is addressed directly rather than fragmented and left to clear, single-session success rates are high. The trade-offs are that a scope must traverse the ureter, and a temporary stent is usually left in place afterward to prevent swelling from obstructing the kidney. That stent is the part most patients remember. Learn more about kidney stones.
Why It's Chosen
Benefits of Ureteroscopy
High Single-Session Clearance
Most stones are cleared completely in one procedure, with less reliance on passing fragments afterward.
Works Anywhere in the Urinary Tract
Flexible scopes reach stones in the ureter and throughout the kidney, including locations unsuited to other approaches.
Effective for Hard Stones
Laser energy fragments compositions that resist shock waves, making it the answer when lithotripsy has failed or wouldn't work.
No Incisions
Access is entirely through the natural urinary tract.
Immediate Confirmation
The surgeon sees the stone cleared rather than waiting weeks of imaging to find out whether treatment worked.
Who Qualifies
Am I A Candidate?
Ureteroscopy suits stones throughout the ureter and kidney, including those that are too hard for lithotripsy, in positions where shock waves don't work well, or in patients where lithotripsy is contraindicated. It is often the preferred choice for stones causing persistent obstruction, for patients who can't stop blood thinners, and during pregnancy when intervention is needed.
You need to be healthy enough for anesthesia. Very large stone burdens are usually better treated with percutaneous nephrolithotomy, which removes substantial stone volume more efficiently. Active infection must be treated first — operating on an infected, obstructed system is dangerous, and a temporary drainage procedure comes before stone removal in that situation. Certain anatomic abnormalities or prior urinary reconstruction may make access difficult.
You need to be healthy enough for anesthesia. Very large stone burdens are usually better treated with percutaneous nephrolithotomy, which removes substantial stone volume more efficiently. Active infection must be treated first — operating on an infected, obstructed system is dangerous, and a temporary drainage procedure comes before stone removal in that situation. Certain anatomic abnormalities or prior urinary reconstruction may make access difficult.
Recovery Time
What to Expect
Before the Procedure
You'll have imaging, a urine culture to rule out infection, and a medication review. You'll receive fasting instructions and need someone to drive you home.
The Day of the Procedure
Ureteroscopy is performed under general anesthesia and typically takes 30 to 90 minutes depending on stone size, number, and location. A stent is usually placed at the end.
Living With a Stent
Most patients go home with a ureteral stent, and it is worth knowing what to expect: urinary frequency and urgency, blood in the urine, flank discomfort when urinating, and a general awareness of it. This is normal and not a complication. Stents typically stay in for several days to two weeks.
Stent Removal
Removal is a brief office procedure. Some stents have a string left outside the body allowing removal without a scope. Most patients feel markedly better within a day of removal.
The First Week
Expect burning, urgency, and blood in the urine. Drink plenty of fluids. Most people return to desk work within a few days.
Follow-up
We confirm clearance with imaging and review stone composition, which shapes your prevention plan.
Risks & Side Effects
Side Effects
Stent Discomfort
The most common complaint by a wide margin. Urgency, frequency, flank pain with urination, and blood in the urine persist until the stent comes out.
Blood in the Urine
Expected for several days, and often intermittently while a stent is in place.
Urinary Tract Infection
Instrumentation carries an infection risk, treated with antibiotics.
Ureteral Injury
Uncommon, ranging from minor abrasion to, rarely, a tear requiring further intervention.
Ureteral Stricture
Scarring can narrow the ureter later, occasionally requiring treatment.
Residual Fragments
Small fragments occasionally remain and may pass on their own or need further treatment.
Answers to your Ureteroscopy Questions
Frequently Asked Questions
Usually yes, for several days.
Stents keep the ureter open while post-procedure swelling settles and are placed in most cases. They typically stay in from a few days up to two weeks.
It irritates the bladder and kidney.
The stent's ends sit in the bladder and kidney, producing urgency, frequency, and flank discomfort when you urinate. It's expected rather than a sign of a problem, and it resolves quickly once removed.
A brief office procedure, minimal discomfort.
Some stents have a string allowing simple removal; others come out with a small scope in the office. It takes moments and most patients feel much better right afterward.
Higher clearance rate, more invasive.
Ureteroscopy addresses the stone directly with a high single-session success rate, at the cost of a scope and usually a stent. Lithotripsy involves nothing entering the body but relies on passing fragments over weeks.
Often within a few days.
Most people with desk jobs return within two to four days, though stent symptoms can be distracting. Physical work usually warrants waiting until the stent is out.
Likely, without a prevention plan.
Stone formers have a substantial recurrence risk over the following years, but composition analysis and 24-hour urine testing let us target prevention specifically. That's what changes the trajectory.
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