Ureteroscopy with Laser Lithotripsy: Oh, Say Can You See? (Yes, We Really Can See Inside the Kidney!)

Ureteroscopy for Stones
If you are suffering from kidney stone pain, Dr. Bevan-Thomas may recommend Holmium laser lithotripsy to break the stone into small fragments that will pass with your urine.

HOW IS THE URETEROSCOPY WITH LITHOTRIPSY PERFORMED?

Holmium laser lithotripsy can usually be done as an outpatient procedure, but sometimes it can involve a short hospital stay. You will receive general anesthesia, so you’ll snooze right through it.

Dr. B-T will pass the scope through the urine channel to the bladder and then into the ureter (the tube that carries urine from the kidney to the bladder). Occasionally, such as with a persistent stone that has failed ESWL), he will continue up into the kidney.

When he finds a stone, the blasting begins! Dr. B-T will use the laser to blast the stone into tiny bits, exactly like the video game Asteroids. (Remember that one?)

The length of the procedure varies depending on the location and number of stones. You will spend a few hours in recovery, and then most patients go home the same day.

I'VE HEARD THAT I MIGHT NEED A STENT. WHAT'S A STENT?

A ureteral stent is a thin tube that Dr. Bevan-Thomas will place in the ureter — the tube from the kidney to the bladder — during your procedure. Think of it as a tiny straw that keeps the ureter open and allows urine and stone fragments to pass into the bladder more easily.

And yes, you will go home with one. Your ureter is likely to be irritated and can swell after the procedure, making urinating difficult and uncomfortable. Trust us on this one — you’ll be a lot more comfortable with the stent.

OK, YOU'VE CONVINCED ME! SO, WHAT HAPPENS AFTER THE PROCEDURES?

  • It can take anywhere from a few weeks to a month or two for the stone fragments to pass.
  • Hydration is critical! Sometimes the fragments can get stuck in the ureter, which causes more pain. The more fluid you drink, the more the ureter stays open, which increases the chance of fragments passing into the bladder. Once in the bladder, the particles will pass with your urine. Drink plenty of fluids to help them along. Aim for at least eight glasses a day.
  • Dr. Bevan-Thomas may ask you to strain your urine and save the stone fragments so they can be analyzed in the lab.
  • Expect blood in your urine for a few days.
  • You can get back to your regular activities after 24 hours. Walking and other light exercise can help the stone particles pass more quickly.
  • Your stent may have a string attached, like dental floss, dangling from your urethra. Dr. B-T uses this when he thinks that the stent only needs to stay for a few days. The bonus is that you can remove the stent easily at home without a followup appointment. If the stent needs to stay longer, it is routinely removed in the office after an x-ray is done to ensure the stone fragments have passed. Remember: The ureteral stent is a temporary tube and should either be removed or changed every few months. Most stents are removed within the first few weeks after the procedure, but sometimes patients need stents for a longer period of time. These longer stents will need changing every four to six months because minerals in your urine will calcify and cause encrustation, like barnacles on a boat. Let’s keep you and your stent barnacle-free!
  • On your follow-up visit, stop by to get a KUB (x-ray) so we can see if the fragments have passed.

WHAT ARE THE RISKS OF URETEROSCOPIC LITHOTRIPSY?

All surgical procedures have risks, but complications are rare for this procedure. The most common side effects (but not all) are:

  • Pain when the stone particles pass. Dr. B-T will give you pain medication to go home with.
  • Blood in your urine.
  • Urinary blockage if particles get stuck in the ureter. (The stent should prevent this.)
  • Incomplete breakage and passage of stone fragments.

A FINAL WORD

We know that you likely have a lot of questions. Dr. Bevan-Thomas will take the time to have a thorough discussion with you about kidney stones, treatment options, and procedure risks and benefits.

If you have not yet met with Dr. Bevan-Thomas, click the button below to schedule an appointment. Let’s get you back to pain-free living!

Urologist Dr. Richard Bevan-Thomas of Urology Partners
Home - DrBevan-Thomas.com
Locations & Contacts
© Dr. Richard Bevan-Thomas - All rights reserved.
Disclaimer, Privacy, Terms of Use & Accessibility Statement