Ureteroscopic Lithotripsy (URSL)


Ureteroscopic lithotripsy (URSL) is a highly effective and minimally invasive procedure in the treatment of ureteric stones. 

Nowadays, most ureteric stones can be treated with URSL. Traditionally, staged URSL is performed for the management of bilateral ureteric stones.

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What is Ureteroscopic Lithotripsy (URSL)?


Kidney stones are hard substances made up of salts and minerals. As the name suggests, they form within the kidneys but can develop elsewhere in the urinary tract like in the bladder, ureters, or the urethra.

Risk factors for kidney stones are ideally drinking an inadequate amount of water daily. 

For this reason, it is most common in prematurely born infants. It is also more likely to develop in adults between 20 to 50years of age.

What are the Pre treatment steps to be followed?


The doctor will conduct a physical examination accompanied by a few tests like blood and urine analysis. Some imaging tests may also be conducted like an MRI or ultrasound.

You will have to follow the specific instructions regarding eating and drinking before the surgery as instructed. 

Discuss with the doctor about altering the dose of your daily medicines as some may be required to be stopped before the procedure to avoid potential complications.

What is the Treatment for Ureteroscopic Lithotripsy (URSL)?


Pain associated with kidney stones can be managed with narcotic medications prescribed in conjunction with antibiotics to prevent infection.

Extracorporeal shock wave lithotripsy:

This therapy utilizes sound waves to break up larger stones so that the fragments can be passed down through the urine. 

This technique may require light anesthesia as it may cause bruising on the bleeding around the kidney and neighboring organs.

Ureteroscopy: 

The procedure requires general anesthesia. It is a minimally invasive option for treating stones in which the doctor inserts a scope with a camera attached to it down the urethra through the ureter to reach the bladder. 

Stones smaller in size can be removed with additional instruments like a small basket.

Larger stones can be fragmented into smaller pieces with a laser or lithotripsy and then removed. 

In some cases, a stent can be placed to reduce the discomfort due to swelling after the surgery. You may require one to two weeks to recover completely after the surgery.

What is the post surgery care to be taken?


  • Kidney stone prevention can be practiced by drinking adequate amounts of water daily.

  • Eat a healthy diet rich in fiber and reduce the consumption of oxalate-rich foods, salt, and animal proteins to prevent kidney stones.

  • Visit the doctor for follow-up appointments as advised if deemed necessary.

What are the risks of Ureteroscopic Lithotripsy (URSL)?


  • Obesity

  • A diet with excess protein, glucose, or salt content

  • Those who have a history of thyroid conditions and previous gastric bypass surgery

  • Inflammatory bowel diseases that increase calcium absorption

  • Taking certain medications such as diuretics, calcium-based antacids, etc.

  • If kidney stones are left untreated it can cause ureteral spasms and irritation leading to bleeding in the urine. Sometimes the stone can block off the urine flow and cause urinary obstruction, ultimately leading to kidney infection and damage. 

Risks associated with the procedure include:

  • Urethral stent pain

  • Residual stones within the kidney or ureter may be left after surgery

  • Injury to the ureter and other nearby structures

  • Ureteral stricture (scar tissue formation) and avulsion

  • Excessive bleeding 

  • Infection

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