In uteroscopy, a flexible viewing tube (called a ureteroscope) is passed through the urethra and bladder and up the ureter—the tube that connects the bladder to the kidney. Fiberoptic cables permit direct visualization of the ureter and kidney. In addition, various instruments may be passed through the scope to take tissue samples for laboratory examination or to perform therapeutic procedures, such as removal of stones in the ureter or kidney.
Purpose of the Ureteroscopy
- To inspect the ureter and kidney for the presence of small tumors and to remove tissue samples to confirm or rule out a diagnosis of cancer
- Used therapeutically to remove stones in the ureter or kidney or scar tissue that is blocking the flow of urine from the kidney.
Who Performs Ureteroscopy
- A urinary tract specialist (urologist) or another physician.
Special Concerns about Ureteroscopy
- Ureteroscopy is usually performed in a hospital or outpatient facility under general or spinal anesthesia.
- This procedure should be postponed if you currently have a urinary tract infection.
Before the Ureteroscopy
- Drink plenty of fluids on the night before the test, but do not eat or drink anything after midnight.
- At the testing facility, you will be asked to disrobe and put on a hospital gown.
- An intravenous (IV) needle or catheter may be inserted into a vein in your arm immediately before the procedure begins, and any needed medications, such as a sedative or general anesthesia, will be administered.
- If spinal anesthesia is used, the anesthetic medication will be injected into your lower spinal column to numb the lower half of your body. You will remain conscious throughout the procedure.
- If general anesthesia is being used, a thin tube attached to a breathing machine will be inserted through your mouth and into your windpipe to help you breathe.
What You Experience during Ureteroscopy
- You will lie on your back with your knees bent, legs spread apart, and feet resting in stirrups.
- The ureteroscope is gently inserted into the urethra and passed through the bladder into the ureter. It may be guided as far as the kidney, if necessary.
- The doctor visually inspects the area for abnormalities.
- If appropriate, instruments may be passed through the scope to obtain a tissue biopsy for laboratory analysis or to perform therapeutic procedures (such as removal of a stone with a small basket at the end of a wire or laser obliteration of the stone into smaller particles that can then pass out of your body in urine).
- A small flexible tube called a stent may be left in the ureter for 1 to 4 weeks after the procedure to help keep the channel open and allow urine to easily drain into the bladder.
- Once the procedure is complete, the ureteroscope is slowly withdrawn.
- The procedure usually takes about 30 to 45 minutes but may take longer if large or multiple stones need to be removed from the upper ureter or kidney.
Risks and Complications of Ureteroscopy
- If general anesthesia is necessary, the procedure carries the associated risks.
- Rare complications include infection, inadvertent perforation of the bladder or ureter, and formation of a stricture (narrowing) or scar tissue weeks or months after a significant perforation.
After the Ureteroscopy
- You will remain in a recovery room until the effects of the anesthetic subside. During this time, your vital signs will be monitored, and you will be observed for any signs of complications.
- Arrange for someone to drive you home after the procedure.
- Drink plenty of fluids (but no alcohol) to prevent accumulation of bacteria in the bladder and to reduce the slight burning sensation that may occur during urination (which may persist for 1 or 2 days).
- You may be given an antibiotic to reduce the risk of infection.
- If you have a stent, you may experience a sense of increased urgency to urinate. Your doctor may prescribe medication to minimize this problem.
- It is common to have a pink tinge to your urine for about 24 hours (or the entire time that a stent remains in place). However, if bright red blood or blood clots are present, notify your doctor.
- Call your doctor immediately if you experience pain in your back, stomach, or side, urinary difficulties, chills, or fever.
- If you have a ureteral stent, your doctor will remove it in 1 to 4 weeks using a simple procedure that does not require anesthesia.
Results of Ureteroscopy
- The doctor will note any abnormalities during the visual inspection of your urinary tract. If a stone is detected in your ureter or kidney, it will be removed during the procedure.
- If tissue samples were taken, the specimens will be sent to a pathology laboratory and examined under a microscope for the presence of unusual cells.
- This test usually results in a definitive diagnosis. Your doctor will recommend an appropriate course of medical or surgical treatment, depending on the specific problem.
The Johns Hopkins Consumer Guide to Medical Tests
Simeon Margolis, M.D., Ph.D., Medical Editor
Updated by Remedy Health Media