What is Ureteroscopy

Ureteroscopy is a procedure to check for and treat problems inside part of the urinary tract. In this procedure, a thin, tube-shaped instrument with a light at the end (ureteroscope) is used to look at the inside of the kidneys and the ureters, which are the tubes that carry urine from the kidneys to the bladder. The ureteroscope is inserted into one or both of the ureters.

You may need this procedure if you have frequent urinary tract infections (UTIs), blood in your urine, or a stone in one of your ureters. A ureteroscopy can be done to find the cause of urine blockage in a ureter and to evaluate other abnormalities inside the ureters or kidneys. If stones are found, they can be removed during the procedure. Polyps, abnormal tissue, and some types of tumors can also be removed or treated. The ureteroscope may also have a tool to remove tissue to be checked for disease under a microscope (biopsy).

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Bleeding.
• Infection.
• Allergic reactions to medicines.
• Scarring that narrows the ureter (stricture).
• Creating a hole in the ureter (perforation).

What happens before the procedure?

Staying hydrated

Follow instructions from your health care provider about hydration, which may include:

• Up to 2 hours before the procedure – you may continue to drink clear liquids, such as water, clear fruit juice, black coffee, and plain tea.

Eating and drinking restrictions

Follow instructions from your health care provider about eating and drinking, which may include:

• 8 hours before the procedure – stop eating heavy meals or foods such as meat, fried foods, or fatty foods.
• 6 hours before the procedure – stop eating light meals or foods, such as toast or cereal.
• 6 hours before the procedure – stop drinking milk or drinks that contain milk.
• 2 hours before the procedure – stop drinking clear liquids.

Medicines

• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood. Do not take these medicines before your procedure if your health care provider instructs you not to.
• You may be given antibiotic medicine to help prevent infection.

General instructions

• You may have a urine sample taken to check for infection.
• Plan to have someone take you home from the hospital or clinic.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins.
• You will be given one of the following:
  • A medicine to help you relax (sedative).
  • A medicine to make you fall asleep (general anesthetic).
  • A medicine that is injected into your spine to numb the area below and slightly above the injection site (spinal anesthetic).
• To lower your risk of infection, you may be given an antibiotic medicine by an injection or through the IV tube.
• The opening from which you urinate (urethra) will be cleaned with a germ-killing solution.
• The ureteroscope will be passed through your urethra into your bladder.
• A salt-water solution will flow through the ureteroscope to fill your bladder. This will help the health care provider see the openings of your ureters more clearly.
• Then, the ureteroscope will be passed into your ureter.
  • If a growth is found, a piece of it may be removed so it can be examined under a microscope (biopsy).
  • If a stone is found, it may be removed through the ureteroscope, or the stone may be broken up using a laser, shock waves, or electrical energy.
  • In some cases, if the ureter is too small, a tube may be inserted that keeps the ureter open (ureteral stent). The stent may be left in place for 1 or 2 weeks to keep the ureter open, and then the ureteroscopy procedure will be performed.
• The scope will be removed, and your bladder will be emptied.

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored until the medicines you were given have worn off.
• You may be asked to urinate.
• Do not drive for 24 hours if you were given a sedative.

Ureteroscopy, Care After

This sheet gives you information about how to care for yourself after your procedure. Your health care provider may also give you more specific instructions. If you have problems or questions, contact your health care provider.

What can I expect after the procedure?

After the procedure, it is common to have:

• A burning sensation when you urinate.
• Blood in your urine.
• Mild discomfort in the bladder area or kidney area when urinating.
• Needing to urinate more often or urgently.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, take it as told by your health care provider. Do not stop taking the antibiotic even if you start to feel better.

General instructions

• Do not drive for 24 hours if you were given a medicine to help you relax (sedative) during your procedure.
• To relieve burning, try taking a warm bath or holding a warm washcloth over your groin.
• Drink enough fluid to keep your urine clear or pale yellow.
  • Drink two 8-ounce glasses of water every hour for the first 2 hours after you get home.
  • Continue to drink water often at home.
• You can eat what you usually do.
• Keep all follow-up visits as told by your health care provider. This is important.
  • If you had a tube placed to keep urine flowing (ureteral stent), ask your health care provider when you need to return to have it removed.

Contact a health care provider if:

• You have chills or a fever.
• You have burning pain for longer than 24 hours after the procedure.
• You have blood in your urine for longer than 24 hours after the procedure.

Get help right away if:

• You have large amounts of blood in your urine.
• You have blood clots in your urine.
• You have very bad pain.
• You have chest pain or trouble breathing.
• You are unable to urinate and you have the feeling of a full bladder.