Ureteroscopic kidney removal (by scope) may be needed for mid- and lower-ureter stones, and can be used when shockwave therapy is not appropriate or doesn't work. The procedure works well for small-to-medium sized stones.
A surgeon inserts a small fiberoptic instrument (ureteroscope) through the bladder (via the urethra for males) and into the ureter (the small tube that drains urine from the kidney to the bladder) or the kidney. No incisions are made. The scope is lighted and equipped with a small camera. Once the surgeon locates the stones, a small, basket-like device can be used to grasp smaller stones and remove them. If a stone is too large to remove in one piece, it can be fragmented into smaller pieces using a special instrument that shatters the stone with laser energy.
A small tube or stent may be left in the ureter for a few days to help urine flow and relieve swelling. Stent removal is performed quickly and easily without the need for anesthesia. Ureteroscopy and laser lithotripsy are typically performed as a same-day procedure with the patient under general or local anesthesia.