Ureteroscopy with laser lithotripsy

A thin telescope is passed through the urethra and bladder up into the ureter or kidney, and a laser breaks the stone into dust or small pieces that are removed or passed in your urine. There are no cuts on the skin.

Also called URS, ureteroscopy, laser lithotripsy, holmium laser lithotripsy, thulium fiber laser, flexible ureteroscopy, retrograde intrarenal surgery, RIRS

Where
Hospital or outpatient surgery center operating room
Anesthesia
General anesthesia (fully asleep), sometimes spinal anesthesia
Time in the room
30 to 90 minutes; longer for large kidney stones
Hospital stay
Same day in most cases
Going home with
Often a ureteral stent for 3 to 14 days, sometimes with a string so it can be pulled out at home
Back to normal
2 to 7 days, or once the stent is out
Back to work
2 to 3 days for desk work; heavy physical work usually after the stent is removed
See the steps
Left kidneyLeft ureterBladderUrethraStone
Where it happens. The highlighted part is what this procedure treats.

Overview

Ureteroscopy is the most common operation for kidney and ureter stones in the United States. Your surgeon passes a ureteroscope, a telescope thinner than a pencil, in through the urethra (the tube that carries urine out of your body), through the bladder, and up the ureter (the tube that carries urine from the kidney to the bladder). Nothing is cut on the skin. A laser fiber about as thin as fishing line goes through the scope to break the stone.

There are two kinds of ureteroscope. A semi-rigid scope, which is straight, works well for stones in the lower and middle ureter. A flexible scope bends at its tip to reach stones in the upper ureter and inside the kidney. The laser is usually a holmium laser or a newer thulium fiber laser. Both can break stones of any hardness.

Your surgeon can use the laser in two ways. Dusting turns the stone into fine sand that washes out in your urine over the following days and weeks. Fragmenting splits the stone into pieces that are pulled out one by one with a tiny wire basket. Many surgeons combine the two. Studies comparing them show similar results, so the choice depends on your stone and your surgeon's practice.

At the end, many people get a ureteral stent, a soft plastic tube that sits inside you from the kidney to the bladder, for a few days to two weeks. It keeps urine draining while the ureter heals from swelling. For many people the stent is the most uncomfortable part of the whole experience. After a short, uncomplicated procedure, your surgeon may decide you do not need one.

The parts of your body involved

Your kidneys sit high in the back of your belly, tucked under the lower ribs on each side. Inside each kidney, urine collects in small cup-shaped chambers called calyces and flows into a funnel called the renal pelvis. From there the ureter, a muscular tube about 10 to 12 inches (25 to 30 centimeters) long and only a few millimeters wide inside, carries urine down to the bladder. Stones form in the kidney. When one breaks loose, it tends to stick at the ureter's narrow spots: where it leaves the kidney, where it crosses the blood vessels to the leg, and where it enters the bladder. A stuck stone backs up urine, which stretches the kidney (hydronephrosis) and causes the severe, wave-like pain called renal colic.

  • Kidney

    Filters blood and makes urine. It sits under the lower ribs, toward your back.

  • Calyces and renal pelvis

    The cup-shaped chambers and the funnel inside the kidney where urine collects. Kidney stones usually sit here. The lowest cups (the lower pole) drain uphill, so pieces there clear more slowly.

  • Ureter

    The narrow tube from kidney to bladder. It squeezes in waves to move urine down. A stone stuck here causes most stone pain.

  • Ureter opening in the bladder

    The ureter enters the bladder through a short tunnel in the bladder wall. This is the narrowest point and the most common place for a stone to stick.

  • Bladder and urethra

    The path the scope takes on the way up. They are not cut, but they can burn and feel sore for a day or two.

Why it’s done

Most stones smaller than 5 millimeters pass on their own within a few weeks. Bigger stones are less likely to pass, and some stones cause problems that should not wait. Ureteroscopy is offered when a stone is unlikely to pass, when waiting is not safe, or when a kidney stone is causing trouble.

  • The stone is too big to pass

    Stones larger than about 10 millimeters (0.4 inch) rarely pass on their own, and many between 5 and 10 millimeters get stuck.

  • Pain that will not settle

    Repeated emergency visits, pain that medicines do not control, or vomiting that stops you from drinking are all reasons to remove the stone.

  • The stone has not moved

    If a stone is still stuck after about 4 to 6 weeks, the chance it will pass drops and the risk to the kidney rises.

  • Blockage with infection

    A blocked, infected kidney is an emergency. The first step is drainage with a stent or a nephrostomy tube plus antibiotics. Ureteroscopy is done later, once the infection has cleared.

  • Protecting kidney function

    A single kidney, a kidney that already works poorly, or blockage on both sides calls for earlier treatment.

  • Kidney stones that cause trouble

    Stones sitting in the kidney that bleed, cause infections or pain, or keep growing on scans. Pilots and people who travel to remote places may choose treatment for safety.

Other options

  • Waiting, with medicine to help the stone pass

    For a stone up to about 10 millimeters in the ureter, with pain under control and no infection, you can try to pass it for up to 4 to 6 weeks. Tamsulosin, a pill that relaxes the ureter muscle, helps some stones pass, especially larger stones in the lower ureter. You strain your urine to catch the stone.

  • Shock wave lithotripsy

    Shock waves from a machine outside the body break the stone without a scope. It works best for kidney or upper ureter stones under 1 to 2 centimeters that are not too hard. It is less likely than ureteroscopy to clear the stone in one session, and it rarely needs a stent.

  • Percutaneous nephrolithotomy (PCNL)

    A keyhole operation through the back, preferred for kidney stones larger than about 2 centimeters and for larger stones in the lowest part of the kidney.

  • A stent or nephrostomy tube first

    When the kidney is infected or you are too unwell for stone surgery, a stent or a tube through the back drains the kidney first. The stone is treated later.

  • Medicine to dissolve uric acid stones

    Uric acid stones can sometimes dissolve when the urine is made less acidic with potassium citrate or a similar medicine. This takes weeks to months and does not work for the more common calcium stones.

  • Watching a kidney stone that causes no trouble

    Small stones sitting quietly in the kidney, with no pain, blockage or infection, can often be watched with periodic scans while you work on prevention.

Getting ready

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Weeks before

The week before

The day before

The morning of

In the operating room, step by step

Press play or pick a step. Each drawing shows what your surgeon is doing at that moment. Your team may do some steps differently.

YouLeg supportsAnesthesia team
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1. Going to sleep and getting positioned

You lie on your back and the anesthesiologist puts you fully to sleep. Your legs are then raised and rested in padded stirrups. This position, called lithotomy, gives your surgeon a straight path to the urethra.

More detail

The team pads pressure points and moves both legs together to protect your hips and knees. Being fully asleep keeps you still, which matters when the laser is working a few millimeters from the lining of the ureter.

  1. You lie on your back and the anesthesiologist puts you fully to sleep. Your legs are then raised and rested in padded stirrups. This position, called lithotomy, gives your surgeon a straight path to the urethra.

    More detail

    The team pads pressure points and moves both legs together to protect your hips and knees. Being fully asleep keeps you still, which matters when the laser is working a few millimeters from the lining of the ureter.

  2. A C-arm, a portable X-ray machine, is brought over your belly so your surgeon can see the stone, wires and scope in real time. The camera image is shown on a large screen. Nothing on your skin is cut.

    More detail

    The X-ray dose for a ureteroscopy is usually small, and teams use short pulses to keep it as low as possible. If there is any chance you are pregnant, the team must know beforehand.

  3. Your surgeon first passes a cystoscope, a thin telescope, through the urethra into the bladder. Sterile salt water fills the bladder so the lining can be seen. The surgeon finds the opening of the ureter on the side of the stone.

  4. Contrast dye may be gently injected up the ureter to outline it on X-ray, showing exactly where the stone is and how swollen the kidney is. A soft, thin guidewire is then passed up the ureter into the kidney. It stays in place as a safety line for the whole procedure.

    More detail

    The dye picture is called a retrograde pyelogram. The safety wire means a stent can be placed quickly at any point, even if the view becomes cloudy with blood.

  5. The ureteroscope slides up the ureter beside the wire. A steady flow of salt water through the scope opens the ureter gently so the surgeon can see. A straight semi-rigid scope is often used for stones low in the ureter, and a flexible scope for higher stones and kidney stones.

  6. On the screen, the ureter looks like a narrow pink tunnel. The stone sits wedged in it, often with swollen lining around it. The surgeon judges its size and whether a small stone can be grabbed whole without breaking it.

  7. A laser fiber is passed through the scope until its tip touches the stone. Rapid pulses of laser energy chip the stone into dust and small pieces. The laser only works right at its tip, so the surgeon keeps it on the stone and away from the ureter lining.

    More detail

    Holmium lasers have been the standard for decades. Thulium fiber lasers are newer and tend to make finer dust. Both break every kind of stone, including very hard stones that shock waves cannot break.

  8. For stones inside the kidney, the surgeon uses a flexible ureteroscope that bends at its tip to look into each calyx. Many surgeons first place an access sheath, a smooth hollow tube in the ureter, so the scope can pass in and out easily and fluid can drain.

    More detail

    The access sheath helps keep pressure inside the kidney low and lets pieces come out quickly. If the ureter is too tight for it, the surgeon may skip it, or stop and place a stent so the ureter can widen for a second try in 1 to 2 weeks.

  9. With the laser on the stone, the surgeon chooses between dusting and fragmenting. Dusting uses quick, gentle pulses to wear the stone into fine sand that you pass in your urine. Fragmenting uses stronger pulses to split the stone into pieces small enough to pull out.

    More detail

    In a multicenter trial comparing the two, stone-free rates at follow-up were similar. Dusting was quicker, while basketing removed more stone during the operation and gave more material for testing. Many surgeons blend both in the same case.

  10. Through the scope, the stone glows in the laser's aiming beam. With each burst, a cloud of fine dust drifts off. The salt water flow washes the dust away so the surgeon can keep working.

  11. A tiny wire basket, folded inside a thin sheath, is opened around a fragment and closed to hold it. The surgeon pulls the piece out through the access sheath or the ureter. Some pieces go to the lab to find out what the stone is made of.

  12. The flexible scope is turned into each calyx, top to bottom, to look for leftover pieces. Bits smaller than about 2 millimeters are usually left to wash out on their own. The camera view and an X-ray confirm the kidney is as clear as it can safely be.

    More detail

    Pieces in the lowest calyx are the hardest to clear because they have to travel uphill to leave. Sometimes the surgeon carries a stone from the lower pole to an upper calyx with the basket before breaking it there.

  13. The scope comes out, and in many cases a stent is slid up over the safety wire. One curl sits in the kidney and the other in the bladder, so urine keeps draining while the ureter heals. Sometimes a thread is left tied to the stent and taped to your skin, so the stent can be pulled out later without another scope.

    More detail

    AUA guidelines allow leaving out the stent after a short, uncomplicated ureteroscopy in selected patients. Surgeons usually place one after a long case, when an access sheath was used, when the ureter was injured or tight, with a single kidney, or when pieces remain.

  14. The lower curl of the stent rests on the bladder floor near the ureter opening. This area is very sensitive, so it can make you feel you need to urinate often. When you urinate, a little urine can also push back up the stent to the kidney, which causes a brief ache in your side. These feelings go away once the stent is out.

After the operation

Right afterward

  • Waking up

    You wake in the recovery room a few minutes after the procedure. Burning in the urethra, a strong urge to urinate and an ache in your side are expected. Most people go home within 1 to 2 hours.

  • Urinating before you leave

    Many centers ask you to urinate before going home. Pink or red urine is normal.

  • If your stent has a string

    The string comes out of the urethra and is taped to your thigh or penis. The nurse shows you how to keep it secure and tells you the date to remove it.

  • Your medicines

    You usually go home with a pain plan and often medicines for stent discomfort, such as tamsulosin and a bladder relaxer.

  • Getting home

    An adult must drive you. Do not drive, sign important papers or drink alcohol for 24 hours after anesthesia.

At home

  • Pain and stent discomfort

    Side ache, bladder spasms and frequent urges are common while a stent is in. Anti-inflammatory pain pills such as ibuprofen work well for stent pain if your kidney function allows them. Tamsulosin and a bladder relaxer such as oxybutynin or solifenacin help many people. Phenazopyridine eases burning for a day or two and turns urine bright orange. If you take an opioid, add a stool softener to avoid constipation.

  • Blood in the urine

    Pink to red urine comes and goes while a stent is in, especially after activity. Drinking more usually clears it. Small clots can happen. Thick clots, urine like ketchup, or trouble passing urine need a call.

  • Drink plenty

    Drink enough to keep your urine pale yellow, for most people about 2.5 to 3 liters (10 to 12 cups) a day, unless a doctor has limited your fluids.

  • Activity

    Walk from the first day. Normal daily activity is fine. Running, hard exercise and heavy lifting tend to make stent pain and bleeding worse, so most people wait until the stent is out.

  • Driving

    No driving for at least 24 hours after anesthesia or while taking opioid pain medicine. After that, drive when you can turn and brake comfortably.

  • Showering

    You can shower the next day. If you have a string, keep it taped and pat it dry afterward.

  • Work

    Many people return to desk work in 2 to 3 days. Jobs with heavy labor or long drives are often easier after the stent is out.

  • Sex

    Sex is safe when you feel comfortable. Tape a string out of the way. Some people find sex uncomfortable until the stent is removed.

  • Stent removal date

    Know your removal date before you leave. A string stent is usually pulled out at home or in the office 3 to 7 days after surgery. A stent without a string is removed with a quick office cystoscopy. A stent left in too long can crust over, so never let the date pass without a plan.

  • Preventing the next stone

    The stone is usually sent for analysis, and people with repeat stones or higher risk are often asked to do a 24-hour urine test. Steps that help most people: drink enough to make about 2.5 liters of urine a day, keep sodium to about 2,300 milligrams a day or less, eat normal amounts of calcium from food (about 1,000 to 1,200 milligrams a day), go easy on meat, poultry and seafood, eat plenty of fruits and vegetables, and avoid sugar-sweetened drinks. With calcium oxalate stones you may be asked to limit high-oxalate foods such as spinach, nuts and rhubarb, and to skip high-dose vitamin C supplements.

Recovery timeline

  1. Day 0
    Home the same day

    Burning, urges and pink urine are expected. Rest, drink, and take your medicines on schedule.

  2. Days 1 to 3
    Stent symptoms peak

    Side ache when you urinate, frequent urges and blood that comes and goes are usual. Most people are up and about at home.

  3. Days 3 to 14
    The stent comes out

    A string stent is often removed at 3 to 7 days. A stent without a string is removed in the office, often within 1 to 2 weeks. Longer if the ureter was injured or tight.

  4. Removal day
    A few hours of cramping for some

    Some people get a short spell of strong side pain a few hours after removal as the ureter adjusts. An anti-inflammatory pill helps if you are allowed one.

  5. Weeks 1 to 4
    Dust passes

    You may see sand or grit in your urine. Most activity is back to normal once the stent is out.

  6. Weeks 4 to 8
    Follow-up scan

    An ultrasound, X-ray or low-dose CT checks that the kidney drains well and looks for leftover pieces. Many surgeons order this even if you feel fine, because a narrowing can block a kidney without pain.

  7. Months 1 to 3
    A prevention plan

    The stone analysis and, for many people, a 24-hour urine test guide diet changes or medicines that lower the chance of another stone.

  8. Long term
    Staying stone-free

    Stones often come back. Without prevention, up to half of people form another stone within 5 to 10 years. Steady fluids and diet changes lower that risk.

What it feels like

Most people say the operation itself was easy because they slept through it. The stent is what they remember. Knowing what is normal makes those days easier to get through.

  1. The night before

    You may still have stone pain, or a dull fear of it coming back. Many people worry about the stent they have heard about from friends, or about missing work.

    What helpsWrite down your questions for the morning. Ask whether you will have a stent and for how long. Pack your pain medicines and a water bottle for the ride home.

  2. Waking up

    Burning in the urethra and a strong urge to urinate, even with an empty bladder. Your side may ache like a bruise. Some people feel cold or shaky as the anesthesia wears off.

    What helpsTell the nurse about pain early. Warm blankets help. The urge eases as the bladder settles.

  3. The first time you urinate

    Burning at the tip of the urethra, pink urine, and often a sharp ache in your side right as you urinate. That side ache is urine pushing back up the stent, and it fades within a minute or so.

    What helpsDrink steadily so the urine stays dilute. Take your time and breathe out slowly while you go.

  4. Living with the stent

    Frequent trips to the bathroom, a feeling of not quite emptying, and a pulling ache in the side or bladder, often worse after walking or at night. Many people are surprised by how tiring it is. Frustration is common.

    What helpsTake the stent medicines on a regular schedule rather than waiting for pain. A heating pad on your side or lower belly helps. Plan easy days and remind yourself it is temporary.

  5. The string

    If your stent has a string, you may feel self-conscious about it and worry about catching it on clothing or pulling it out by accident.

    What helpsTape it with a little slack and wear snug underwear. If it comes out early, call your team. It is only urgent if pain or fever follows.

  6. Stent removal

    Pulling a string stent feels like a long, slippery slide, over in a few seconds. Office removal with a scope takes about a minute and feels like pressure and a brief sting.

    What helpsBreathe out slowly as it comes out. Ask whether to take an anti-inflammatory pill an hour before. Keep the afternoon free in case you cramp.

  7. Passing the dust

    For a week or two you may see grit or sand in the toilet, sometimes with a twinge. Many people find it oddly satisfying to see.

    What helpsStrain your urine if your surgeon wants pieces. Keep drinking to wash out the rest.

  8. Afterward

    Relief, and often a new worry: will this happen again?

    What helpsAsk for your stone analysis and a prevention plan. The habits that prevent stones are simple, and they work best when started now.

How well it works

Success means the stone is gone or only tiny fragments remain, the kidney drains normally, and the pain is over. For stones in the ureter, about 9 in 10 people are stone-free after one ureteroscopy. Larger kidney stones are more likely to need a second procedure.

  • Stone-free status

    A follow-up ultrasound, X-ray or low-dose CT, usually 4 to 8 weeks later, shows whether any pieces remain. Very small fragments often pass or stay quiet, and are watched.

  • Kidney drainage

    The same scan confirms the kidney is no longer swollen, which rules out a silent blockage or narrowing.

  • Stone analysis

    The lab reports what the stone is made of, such as calcium oxalate, calcium phosphate, uric acid, struvite or cystine. Each type has its own prevention plan.

  • 24-hour urine test

    For people with more than one stone, or at higher risk, collecting all urine for a full day shows the chemistry behind the stones and guides diet changes or medicines.

Risks

Every operation has risks. These are the ones people ask about most, with honest odds where good numbers exist. Your surgeon’s own results matter more than averages.

Common

Stent discomfortMost people who have a stent

Urges, frequent urination, burning, and side pain when you urinate while the stent is in. It ends when the stent is removed.

Blood in the urineAlmost everyone

Pink or red urine for a few days, and on and off while a stent is in.

Burning with urination

Usually lasts 1 to 3 days.

Leftover fragments

Small pieces may remain, especially after large kidney stones. Many pass on their own. Some need a second procedure.

Less common

Urinary infection or feverAbout 1 to 5 in 100 people

Fever after ureteroscopy usually responds to antibiotics. Testing and treating the urine before surgery lowers the risk.

Ureter too narrow to reach the stone

If the scope cannot pass safely, the surgeon places a stent and returns in 1 to 2 weeks, once the ureter has widened.

Pain after stent removal

A few hours of strong cramping side pain as the ureter adjusts. It usually settles with anti-inflammatory medicine.

Stent slipping or falling out early

More likely with a string stent. Call your team if it comes out before the planned date.

Small tear in the ureter lining

Usually heals on its own over a stent left in a little longer.

A second procedure

More likely when a kidney stone is larger than about 1.5 to 2 centimeters or sits in the lowest part of the kidney.

Rare

Ureteral stricture

Scar tissue can narrow the ureter weeks to months later and block the kidney, sometimes without pain. This is one reason for the follow-up scan. It may need a dilation, a stent or surgery.

Serious infection (sepsis)

Infection that spreads to the blood and needs hospital care with IV antibiotics, sometimes in intensive care.

Severe ureter injury

A major tear that needs open or robotic repair is very rare.

Forgotten stent

A stent left in for many months can become crusted with stone and hard to remove, sometimes needing more surgery. Keeping your removal date prevents this.

Call your care team or go to the emergency room if

  • Fever of 101°F (38.3°C) or higher, or shaking chills
  • Pain in your side or belly that your prescribed medicines do not control
  • You cannot urinate, or your bladder feels full and painful and will not empty
  • Thick clots, urine that looks like ketchup, or bleeding that does not lighten after you drink more
  • Vomiting that keeps you from holding down fluids or medicines
  • The stent or its string comes out before the planned date, or the removal date passes without a plan
  • Chest pain, shortness of breath, or a swollen, painful leg (call 911 for chest pain or trouble breathing)

Questions to ask your surgeon

  1. Where exactly is my stone, how big is it, and how hard does it look on the CT scan?
  2. Why do you recommend ureteroscopy for me rather than shock waves, PCNL, or more time to pass it?
  3. Will you use a flexible scope, and will you place an access sheath?
  4. Do you plan to dust the stone, remove pieces with a basket, or both?
  5. Will I have a stent? For how long, and will it have a string?
  6. What medicines will you give me for stent discomfort?
  7. How likely is it that I will need a second procedure?
  8. Do I need to stop my blood thinner, and who tells me when to restart it?
  9. Will my stone be analyzed, and should I do a 24-hour urine test?
  10. When is my follow-up scan, and what kind will it be?
  11. When can I go back to work, exercise or travel?

Words you may hear

Ureteroscope
A thin telescope, straight (semi-rigid) or bendable (flexible), passed up the ureter to see and treat stones.
Ureter
The narrow muscular tube that carries urine from each kidney to the bladder.
Calyx
One of the small cup-shaped chambers inside the kidney where urine first collects. Plural: calyces.
Renal pelvis
The funnel in the center of the kidney where the calyces drain before urine enters the ureter.
Laser lithotripsy
Breaking a stone with laser energy. Lithotripsy means stone breaking.
Holmium and thulium lasers
The two kinds of laser used to break urinary stones. Both work only at the tip of a thin fiber.
Ureteral stent
A soft plastic tube with a curl at each end that sits inside the ureter from kidney to bladder to keep urine draining.
Access sheath
A smooth hollow tube placed in the ureter so a flexible scope can pass in and out easily.
Basket
A tiny wire cage that opens around a stone fragment so it can be pulled out.
Dusting
Using quick, gentle laser pulses to turn a stone into fine sand that passes in the urine.
Fragmenting
Using the laser to split a stone into pieces that are then removed with a basket.
Hydronephrosis
Swelling of the kidney's drainage system because urine is backed up behind a blockage.
Fluoroscopy
Live X-ray pictures used during the procedure to guide wires, scopes and stents.
24-hour urine test
Collecting all your urine for a full day so a lab can measure the chemicals that cause stones.

Common questions

Will I definitely have a stent?

Not always. After a short, uncomplicated procedure for a stone in the ureter, many surgeons leave the stent out. A stent is more likely after kidney stone work, when the ureter was tight or swollen, when an access sheath was used, or when pieces remain. Your surgeon often makes the final decision at the end, based on what they see.

Can I keep my stone?

The pieces are usually sent to the lab, because knowing the stone type guides prevention. Ask if you would like any leftover pieces or a photo. A dusted stone may leave little to see.

Why can't the laser clear a big stone in one go?

The ureter and kidney are small and delicate, and large stones take a long time to break. Surgeons limit operating time and fluid pressure inside the kidney to lower the risk of infection. For very large stones, a planned second session or PCNL can be safer.

Is ureteroscopy safe if I take a blood thinner?

Ureteroscopy is often the preferred stone treatment for people who cannot stop blood thinners, because nothing is cut. Bleeding is still more likely, so the decision is made with you and the doctor who prescribes the medicine.

Why does my side hurt when I urinate with the stent in?

The stent holds open the natural valve where the ureter enters the bladder. When you urinate, pressure pushes a little urine back up to the kidney and stretches it briefly. It is harmless and stops when the stent comes out.

Can I fly or travel with a stent?

Yes. A stent does not set off airport security. Carry your medicines, drink well, and plan the trip around your removal date.

What can I eat to prevent another stone?

The most helpful step is drinking enough to make about 2.5 liters of urine a day. Eat less salt and less meat, keep normal calcium from food (calcium binds oxalate in the gut), eat plenty of fruits and vegetables, and skip sugary sodas. Your stone type and 24-hour urine results may add specific steps, such as limiting high-oxalate foods or taking potassium citrate.

How soon will I know if it worked?

Your surgeon can tell you right after the procedure how much stone was cleared. The follow-up scan a few weeks later confirms it.

Sources this page draws on

  • American Urological Association and Endourological Society, Surgical Management of Stones: AUA/Endourological Society Guideline (2016)
  • American Urological Association, Medical Management of Kidney Stones: AUA Guideline (2014)
  • European Association of Urology, EAU Guidelines on Urolithiasis
  • EDGE Research Consortium, Journal of Urology, Dusting versus basketing during ureteroscopy: a prospective multicenter randomized trial (2018)
  • National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Kidney Stones
  • Urology Care Foundation, Kidney Stones

Written November 2026. This page explains what usually happens. It is not medical advice and does not replace a conversation with your own surgeon, whose plan for you comes first.