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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About the Surgery

1.Overview: 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. 


  • Procedure Type: Minimally invasive procedure
  • Anesthesia: General/Local anesthesia
  • Hospitalization: 0-1 day
  • Procedure time: 30 minutes – 2 hours
  • Recovery Time: 2-3 days (few weeks for full recovery)

3.Post-Surgical Care: 

  • Drink lots of fluids. 
  • If there’s a string on your stent, do not pull it until a specified date. On the specified date, you can sit in shower and pull it. 
  • Do not hold urine at all and avoid constipation. 
  • Avoid lifting heavy objects, driving car, strenuous activities, straining during bowel movements. 
  • Keep a urinal nearby. 
  • Take medication as prescribed. Go for follow-up, or when you face issues.

4.Advantages of this Procedure: You’ll be stone-free with a single operation. It is safe and effective, and requires no incisions (cuts). This procedure can treat stones located anywhere in the ureter and kidney. It can be used to treat even pregnant women and obese people.

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.

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.

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.


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.

  • 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.

  • 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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FAQs and Related Articles

The stent will have to stay in place for a period of 5 to 10 days after the surgery.

Make sure that you drink 1 to 1.5 liters of water daily to help flush the bladder daily, discuss with your doctor about any discomfort or unusual signs that you may be experiencing.

A urologist or general surgeon may perform this surgery.

Fatigue, nausea, pain, and discomfort while peeing along with constipation and flatulence are a few of the temporary side effects that should disappear within a few weeks after the surgery.

You may experience some pain after the procedure. Your doctor will prescribe oral narcotic medicines (painkillers) to manage this pain if any.

You can go back to doing all your regular activities in five to seven days after this procedure.

Kidney stones are of various types depending upon its composition. Examining them after the passage or surgery of the kidney stones will help to determine the cause and prevent its recurrence. Oxalate stones and uric acid ones arise from an excess of protein whereas uric acid stones arise due to hereditary condition.

Yes, kidney stones are very common in children as young as 5 years old. The main cause may be drinking less amount of water and eating a diet high in Sodium(salt)-such as junk foods like potato chips, french fries etc. Parents must encourage eating calcium-rich foods and taking adequate amounts of water per day (1.5 litres) as a preventive measure.

The most common way to avoid kidney stones is associated with our diet. Drinking an adequate amount of fluids and eating stone causing food (for example calcium oxalate-rich foods that cause calcium oxalate kidney stones) in moderation are the first line of defence. Other measures include taking special care and addressing any underlying risk factors associated with stones (for example hyperparathyroidism, obesity etc.).

If symptoms appear to be minor at first and not treated by a proper medical professional, it may lead to haematuria (blood in urine) and severe renal colic pain. At a later stage, it may lead to infection, kidney damage, and chronic kidney disease. Hence, prompt treatment is necessary for detection.

Yes, Kidney stones are as common in pregnant women as in the non-pregnant women.

Having foods that are rich in salt, sugar and animal protein may lead to an increased risk with some type of kidney stones. High doses of vitamin D could also lead to kidney stones.

Kidney stones can be of different types. Re-examination is done to ensure that the stones do not recur by determining their cause.

Yes, kidney stones are common in kids as young as 5 years old. It is due to less water consumption and sodium-rich diet (such as junk food).

Minor symptoms not treated can cause blood in urine and severe renal colic pain. Later, it can lead to infection, kidney damage and chronic kidney disease.

Yes, they’re common in both pregnant and non-pregnant women.

People in their 20s and 30s commonly suffer from kidney stones these days.

Food that is rich in calcium, low in sodium and that includes fluids and juices.

Spinach, tomatoes, guava, beetroot and sweet potatoes being high on oxalate content need to be avoided.

No, beer instead promotes formation of kidney stones and can even lead to heartburn.

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