Patient education: Ureteroscopy (The Basics)

What is ureteroscopy? — Ureteroscopy is a procedure that lets the doctor see inside the ureters. Ureters are the tubes that connect the kidneys to the bladder (figure 1). The kidneys make urine. Then, the urine passes through the ureters and into the bladder.

During a ureteroscopy, a doctor puts a thin tube with a tiny camera on the end into the urethra (the tube where urine leaves the body). They move the tube up through the bladder and into the ureters. This tube is called a "ureteroscope."

You might need ureteroscopy to:

●Remove or break up kidney stones – Kidney stones form when salts and minerals that are normally in the urine build up and harden. Sometimes, the whole stone can be removed. Other times, the stone is broken into smaller pieces that pass in your urine.

●Place a stent – A stent is a small metal tube that helps keep the ureter open. This way, urine or small pieces of kidney stone can pass through.

●Check or remove growths or tumors – Some growths or tumors can be a sign of cancer. But this is not always the case. Sometimes, the doctor might take a sample of the growth. Then, they check the sample for signs of cancer or other problems. This is called a "biopsy."

●Check the ureters for narrowing or scarring – These problems can make it difficult for urine to pass through.

How do I prepare for ureteroscopy? — The doctor or nurse will tell you if you need to do anything special to prepare.

Before your procedure, your doctor will do an exam. They might send you to get tests, such as:

●Urine test to check for signs of a urinary tract infection

●Other lab tests

●Imaging tests – Imaging tests create pictures of the inside of the body.

Your doctor will also ask you about your "health history." This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. Tell them about:

●Any medicines you are taking – This includes any prescription or "over-the-counter" medicines you use, plus any herbal supplements you take. It helps to write down and bring a list of any medicines you take, or bring a bag with all of your medicines with you.

●Any allergies you have

●Any bleeding problems you have – Certain medicines, including some herbs and supplements, can increase the risk of bleeding. Some health conditions also increase this risk.

You will also get information about:

●Fasting – This means not eating or drinking anything for a period of time. Whether you need to fast, and for how long, depends on the procedure you are having.

●What help you will need when you go home – For example, you might need to have someone else bring you home or stay with you for some time while you recover.

Ask the doctor or nurse if you have questions or if there is anything you do not understand.

What happens during ureteroscopy? — When it is time for the procedure:

●You will get an "IV," which is a thin tube that goes into a vein. This can be used to give you fluids and medicines.

●You will get general anesthesia medicines – This type of anesthesia makes you unconscious so you can't feel, see, or hear anything during the procedure. If you have general anesthesia, you might get a breathing tube to help you breathe.

●You might get medicines to help control pain after the procedure.

●The doctors and nurses will monitor your breathing, blood pressure, and heart rate during the procedure.

●Your groin area will be washed.

●The doctor will guide the ureteroscope through your urethra and bladder to get to your ureters.

●The doctor will look at your ureters through the camera on the ureteroscope.

●Depending on why you are having the procedure, the doctor might pass tiny tools through the ureteroscope. These can be used to place a stent, take a tissue sample, or remove a kidney stone. Sometimes, a special laser is used to break up a kidney stone into smaller pieces.

●The doctor will slowly take out any tools and the ureteroscope. If a stent was put in, it will stay in the ureter for a few days to a few weeks. Your doctor can tell you exactly how long you will need it. You will have a separate procedure to have it taken out.

What happens after ureteroscopy? — After your procedure, you will be taken to a recovery room. The staff will watch you closely as your anesthesia wears off.

As you recover:

●You might feel groggy or confused for a short time. You might also feel nauseous or vomit. The doctor or nurse can give you medicine to help with this.

●If you had a breathing tube, you might have a sore throat. This usually gets better quickly.

●The staff will help you get out of bed and start moving around when you are ready.

●You will get medicine if needed to help with pain. You might need other medicines, too.

●When you are ready to eat, you will start with clear liquids. Then, you can start eating as you are able. You might feel better if you start with bland foods.

●The staff will make sure that you urinate at least once before you go home.

What are the risks of ureteroscopy? — Your doctor will talk to you about all of the possible risks, and answer your questions. Possible risks include:

●Bleeding

●Infection

●Injury to your kidneys, ureters, bladder, or urethra

What else should I know?

●You will need someone to bring you home after your procedure. Someone should also stay with you for 24 hours.

●Drink plenty of water to help flush out your urinary tract. It is normal to see some blood in your urine for a few days after your procedure.

●If your ureteroscopy was done to place a stent or to help you pass a kidney stone, your doctor or nurse will talk to you about what to expect after your procedure. If you had a stent placed, you will need to have another procedure to remove it.

More on this topic

Patient education: Ureteroscopy – Discharge instructions (The Basics)
Patient education: Ureteral stent placement (The Basics)
Patient education: Ureteral stent removal (The Basics)
Patient education: Kidney stones in adults (The Basics)
Patient education: Kidney stones in children (The Basics)
Patient education: Blood in the urine (hematuria) in adults (The Basics)
Patient education: Blood in the urine (hematuria) in children (The Basics)
Patient education: 24-hour urine collection (The Basics)
Patient education: Lithotripsy for kidney stones (The Basics)

Patient education: Kidney stones in adults (Beyond the Basics)
Patient education: Kidney stones in children (Beyond the Basics)
Patient education: Blood in the urine (hematuria) in adults (Beyond the Basics)
Patient education: Blood in the urine (hematuria) in children (Beyond the Basics)
Patient education: Collection of a 24-hour urine specimen (Beyond the Basics)