URS – Ureteroscopy
How is URS performed?
URS is a type of treatment which is done with a small endoscope. URS is common, success rates are very high, and the risk of complications is low. For URS you will receive general or local anesthesia. Once you are under anesthesia, the doctor enters your bladder with the endoscope through the urethra without making an incision in your body. The stone is pulled out using a special “basket” as shown in figure.
If the stone is too big to be removed completely, it can be fragmented using laser, ultrasound, or a pneumatic lithotripter (which works like a little jackhammer). At this point all stone fragments are removed.
Based on how the operation goes, your doctor may need to place a DJ-stent in the ureter to make sure urine can flow through the urinary system. The stent will be removed when your urine flow is back to normal. This can take anywhere between several days and a few weeks.
Fig. 2: A flexible ureteroscopereach virtually every point within the kidney.
When should patient consider URS?
- If stone is not large (generally under 2 cm), URS is an alternative to SWL. although URS is more invasive than SWL and requires anesthesia.
- It is a safe and effective treatment option for kidney or ureteral stones. Because the stone fragments are removed during the procedure, you don’t have to pass them afterwards.
- Stone-free with a single operation.
When is URS not recommended?
There are few contraindications for URS. In general it can be performed in almost every patient, as long as your condition allows anaesthesia and you do not have an untreated urinary tract infection. URS can even be done without stopping medication for blood clotting. However, it is always important to discuss your individual situation with the doctor.
Operative time and Hospitalization
Usually you can leave the hospital 1 day after the procedure and return to your normal daily activities.