What this procedure is.
Ureteroscopy (URS) is a procedure where a urologist passes a thin camera through the urethra (urine opening), into the bladder, and up the ureter (tube from kidney to bladder) to find a stone. A laser is then used to break the stone into smaller pieces (“laser lithotripsy/fragmentation”). Pieces may be left to pass or removed with a small basket.
Why it’s done.
URS with laser is done to:
- Treat a stone that is not passing on its own, is causing ongoing pain, infection risk, blockage, or kidney problems.
- Clear ureter or kidney stones in a single planned procedure (often as a same-day surgery). Large real-world studies show high success with a low complication rate.
What to expect on the day of surgery.
You will usually have anesthesia (often general anesthesia).
The scope is passed through natural urine channels—no skin cuts.
The laser breaks the stone. Your surgeon may use:
Holmium:YAG laser (most common standard) or thulium fiber laser (TFL) (newer option).
A temporary internal tube called a ureteral stent may be placed to keep urine draining while swelling settles.
How well does it work?
In a large international study of 11,885 ureteroscopy patients, the overall stone-free rate was 85.6%.
Success depends on where the stone is:
Distal (lower ureter): 94.2%
Mid ureter: 89.4%
Proximal (upper ureter): 84.5%
Multiple locations: 76.6% (Prospective global cohort, 9,681 patients.)
Some stones—especially kidney stones—may require more than one procedure to get completely stone free.
Laser types (what this means for you)
Holmium:YAG is the long-time standard. Thulium fiber laser (TFL) is a newer option and may clear kidney stones more effectively in some settings.
In a randomised trial of 120 patients, CT scan at 3 months showed stone-free rates of 67% with holmium vs 92% with TFL; for ureter stones it was 100% in both groups, and for kidney stones 49% vs 86% (p=0.001). Operative time was shorter with TFL (49 vs 57 minutes).
(Your surgeon will choose the laser based on equipment and what’s best for your stone.)
Common short-term symptoms after URS
These are common for several days (sometimes longer), especially if you have a stent:
Burning with urination
Urgency/frequency (feeling like you need to go often)
Blood in the urine
Flank discomfort
Possible risks and complications
Most complications are mild, but serious problems can happen.
Infection (most important to watch for) Infection is the most common concern after URS/RIRS. In a guideline review, typical rates were:
Fever: 4.9%
Sepsis: 0.5%
Ureter injury (tear/perforation): A review reported ureter perforation rates of 0.4%–6.3% in ureterorenoscopy.
Bleeding is usually limited, but rarely can be serious. Large data show transfusion is uncommon:
Blood transfusion: 0.2% in 11,885 ureteroscopy patients.
Ureteral stent: what it is and what to expect
A stent is a soft internal tube from kidney to bladder that helps urine drain and helps the ureter heal.
If you have a stent, you may feel more urgency, burning, or flank pain—especially when you urinate.
Stent removal timing varies by case and surgeon.
What to do at home after surgery
Drink fluids regularly unless your doctor told you not to.
Take medicines exactly as prescribed (pain control, sometimes antibiotics, and sometimes a medication to relax the ureter).
Light activity is usually OK; avoid heavy straining until your doctor says it’s safe.
Seek medical advice if you have:
- Fever or chills
- Severe worsening pain not controlled with your medicines
- Cannot urinate (especially with lower belly pain/pressure)
- Heavy bleeding (thick blood, large clots) or you feel faint
- Repeated vomiting or inability to keep fluids down
Follow-up and imaging
Follow-up often includes imaging to confirm clearance. Ultrasound and X-ray (KUB) are commonly used, and CT can detect very small fragments.
This guide is not a substitute for professional medical advice. If symptoms worsen or you have new concerns, contact your doctor or seek emergency care.