Under general anesthesia, a small lighted telescope called a ureteroscope is inserted into the urethra and guided into the ureter or kidney to the stone. A laser is then passed through the ureteroscope to break the stone into small pieces that are removed from the body. Multiple stones can be treated in one procedure. Ureteroscopy is the only minimally invasive stone surgery that can be performed in patients on blood thinners. Even with this option, it is preferable to stop anticoagulants if it is safe to do so. After this procedure, a temporary flexible drainage tube called a stent is left in place to drain the kidney. It is removed in the office at a later date under local anesthesia.
Occasionally the ureter may be too small to move the ureteroscope safely, so a ureteral stent be placed. This dilates the ureter over time. In this situation a repeat procedure will be necessary and is usually scheduled one to two weeks later. Most patients can return to their daily activities seven to 10 days after surgery or as soon as they are comfortable.