Ureteroscopy: Procedures, Stone Treatment, and Recovery Guidelines
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD | Last reviewed: October 7, 2026
Quick Answer
Ureteroscopy is a common urological procedure in which a thin scope is passed through the urethra to treat stones or blockages in the ureters and kidneys. It is highly effective for stones between 5 mm and 20 mm, which are broken up with lasers. Recovery is generally quick, and a temporary stent may be placed for several days.
What the research says
Routine stenting after an uncomplicated ureteroscopy brings small, uncertain differences. A Cochrane review of randomized trials found that stenting may slightly reduce unplanned return visits (16 trials, 1,970 participants; very low-certainty evidence), probably does not change urinary tract infection rates up to 90 days (RR 0.94, 95% CI 0.59–1.51; 10 trials, 1,207 participants), and may make little or no difference to the need for secondary procedures (RR 1.15, 95% CI 0.39–3.33; 10 studies, 1,435 participants). Stented participants may have more pain on days 4 to 30 (Ordonez et al., Cochrane Database of Systematic Reviews, 2019) [1].
Ureteroscopy clears upper ureteral stones faster, at the price of more complications. A systematic review of 47 studies (19 randomized trials) found that, compared with shock-wave lithotripsy, ureteroscopy had a significantly higher stone-free rate up to 4 weeks (not significant at 3 months) and fewer retreatments, but more complications, longer hospital stays and a higher need for adjunctive procedures such as stent placement. Both options were judged safe and effective (Drake et al., European Urology, 2017) [2].
What Is Ureteroscopy?
Ureteroscopy (URS) is a primary clinical intervention for evaluating and resolving abnormalities within the urinary tract. Unlike traditional surgeries, it requires no external incisions, because the medical team accesses the kidneys and ureters through the body’s natural pathways. This makes it a preferred option for patients with complex health profiles, including those who are pregnant, have obesity, or are managing blood-clotting disorders.
Rigid vs. Flexible Ureteroscopes
The choice between a rigid or flexible ureteroscope depends on the location of the target area. Rigid scopes are typically reserved for issues in the lower ureter near the bladder, while flexible scopes allow urologists to navigate the curves of the upper ureter and the kidney itself. This versatility means even difficult-to-reach stones can often be treated in a single session.
Feature | Rigid ureteroscopy | Flexible ureteroscopy |
Primary use | Lower ureter conditions | Upper ureter and kidney conditions |
Tool design | Straight, non-bending tube | Thin, maneuverable tube |
Target area | Near the bladder | Kidney and upper urinary tract |
Common treatment | Stone removal or stricture repair | Laser fragmentation of kidney stones |
Preparing for the Procedure
Successful outcomes begin with thorough preparation. Patients are typically asked to fast from midnight before the surgery to ensure safety during general anesthesia. A urinalysis is often performed in the weeks leading up to the appointment to rule out active infections, which could complicate recovery. Detailed imaging such as CT scans or MRIs gives the surgical team a precise map of the urinary system.
The Surgical Process
Once general anesthesia is given, the urologist guides the ureteroscope through the urethra and bladder. For smaller stones, a specialized basket may be used to capture and remove the stone intact. For larger obstructions, a laser fiber is passed through the scope to break the stone into “dust” or tiny fragments that can be flushed out or passed naturally during urination.
Recovery Timeline
Recovery milestone | Expected timeline |
Hospital stay | Outpatient (go home the same day) |
Monitoring period | 1–2 hours after the procedure |
Stent removal | A few days to 2 weeks |
Normal activity | Moderate activity (such as walking) is encouraged immediately |
Post-Operative Care and Stents
Many patients have a ureteral stent placed, although it may be skipped after an uncomplicated procedure. This thin tube remains entirely inside the body, connecting the kidney to the bladder to keep the ureter open while the internal tissues heal. While the stent is in place, it is normal to experience some urgency or mild blood in the urine. Proper hydration is essential during this time to flush the kidneys and prevent discomfort.
Conclusion
Ureteroscopy is a highly successful, minimally invasive solution for managing complex urinary stones and blockages. By using advanced laser technology and specialized scopes, urologists can provide effective treatment with minimal downtime and no external scarring. Understanding the procedure and following post-operative guidelines, particularly regarding hydration and stent management, helps ensure a smooth recovery and long-term urinary health.
Next Steps
If you are scheduled for a ureteroscopy, arrange for a driver to take you home afterward. In the days following surgery, prioritize hydration by drinking plenty of water and watch for signs of infection, such as fever or persistent pain. Always attend your follow-up appointment for stent removal as scheduled by your medical team.
Related Reading
Ureteral Stent: Why It's Used, Placement, Side Effects and Removal explains ureteral stents and what to expect.
Nephrostomy Tube: Purpose, Placement and Care explains nephrostomy tubes and how to care for them.
Nephroscopy: Kidney Scope Procedure for Stones, Recovery and Risks explains the kidney scope used to remove large stones.
Frequently Asked Questions
What is the primary purpose of a ureteroscopy?
The primary purpose is to diagnose and treat conditions within the urinary system, most commonly removing or fragmenting kidney and ureteral stones that are too large to pass on their own.
How long does the procedure typically take?
A standard ureteroscopy usually takes between one and two hours, although patients should expect to be at the surgical center for at least four hours to account for preparation and recovery monitoring.
Is ureteroscopy considered major surgery?
No. It is considered a minor, minimally invasive procedure. Because it is performed through natural body openings, no external incisions are required, and it is almost always done on an outpatient basis.
What size stones can be treated with this method?
Ureteroscopy is highly effective for treating stones ranging from 5 millimeters to 20 millimeters in size.
Will I be awake during the procedure?
No. The procedure is typically performed under general anesthesia, meaning you will be asleep and will not feel any pain during the surgery.
Why is a stent necessary after the procedure?
A stent is placed to hold the ureter open, ensuring that urine can drain freely from the kidney to the bladder while the ureter heals from the inflammation caused by the procedure or the stone.
How is the stent removed?
The stent is removed a few days or weeks later. Some stents have a small string for home removal, while others are removed by a healthcare provider in a brief office procedure.
Is it normal to see blood in the urine after surgery?
Yes. It is common and expected to see some blood in the urine for several days after the procedure, especially while the stent is still in place.
When can I return to my normal activities?
Most patients can resume moderate activities like walking immediately. Follow your provider’s specific instructions regarding more strenuous exercise or returning to work.
What are the main risks of ureteroscopy?
While generally safe, risks include infection, injury to the ureter, urinary retention, or scarring that could cause future narrowing of the urinary tract.
Can ureteroscopy be performed during pregnancy?
Yes. Ureteroscopy is often a preferred option for treating symptomatic stones during pregnancy because it avoids the radiation and shockwaves associated with other treatments.
How do urologists break up large stones?
Urologists use a flexible laser fiber passed through the scope to break stones into tiny pieces or dust, which are then flushed out or passed naturally.
What should I do if I have a fever after the procedure?
Contact your healthcare provider immediately if you develop a fever, as this could be a sign of a urinary tract infection that requires treatment.
Does the procedure require any incisions?
No. Ureteroscopy is a “scarless” surgery because the instruments are passed through the urethra, requiring no cuts to the skin.
What happens to the stone fragments?
Small fragments may be removed using a tiny basket, while laser-generated “dust” is flushed out during the procedure or passed naturally when you urinate over the following days.
Sources
Ordonez M, Hwang EC, Borofsky M, Bakker CJ, Gandhi S, Dahm P. Ureteral stent versus no ureteral stent for ureteroscopy in the management of renal and ureteral calculi. Cochrane Database Syst Rev. 2019;2(2):CD012703. PMID 30726554. https://doi.org/10.1002/14651858.CD012703.pub2
Drake T, Grivas N, Dabestani S, et al. What are the benefits and harms of ureteroscopy compared with shock-wave lithotripsy in the treatment of upper ureteral stones? A systematic review. Eur Urol. 2017;72(5):772-786. PMID 28456350. https://doi.org/10.1016/j.eururo.2017.04.016
Cleveland Clinic. Ureteroscopy: Purpose, Procedure, Risks & Recovery. Cleveland Clinic. Last updated March 6, 2026. https://my.clevelandclinic.org/health/treatments/16213-ureteroscopy
Medical disclaimer
This content is for informational purposes only and does not constitute medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Contact your provider right away if you develop a fever after the procedure.
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