03 / URS · laser · contact lithotripsy
Ureteroscopy and contact fragmentation of ureteral stones in Krasnoyarsk
Ureteroscopy lets the surgeon see a ureteric stone and break it under direct endoscopic guidance. An external incision is usually unnecessary, but stone size alone does not determine the need for surgery.
- URS
- Ureteric stones
- Laser
This material was prepared by a doctor using Russian clinical guidelines and EAU guidance. It does not establish a diagnosis, prescribe treatment or replace an in-person consultation. The choice of method depends on investigations, coexisting conditions and individual risks. A surgical outcome cannot be guaranteed in advance.
- Access
- without an external incision
- Monitoring
- direct endoscopic visualisation
- Energy
- laser, pneumatic or ultrasonic
01 / Indications
When ureteroscopy is considered
- low likelihood of spontaneous stone passage
- persistent pain despite pain relief
- persistent ureteral obstruction
- reduced kidney function, bilateral obstruction or a solitary kidney
- unsuccessful shock wave lithotripsy
- the need to assess the ureter and remove the stone at the same time
02 / Decision
Observation, SWL or URS
Stone size matters, but is not the only factor. Position and density, the degree of drainage impairment, infection, ureteric anatomy, kidney function, symptom severity and coexisting conditions are also considered.
If a stone may pass on its own and there are no danger signs, watchful waiting may be possible. With infection and obstruction, the priority is urgent restoration of urine drainage.
03 / Surgery
How contact stone fragmentation is performed
A thin endoscope is passed through the urethra and bladder into the ureter. The stone is removed intact or fragmented using a contact energy source chosen for the situation; fragments are then removed under direct vision.
A stent is inserted for swelling, injury, infection, residual fragments or other indications. It is not mandatory after every uncomplicated procedure.
04 / Preparation
What information to bring
- recent CT in DICOM format and the report
- Ultrasound, if performed
- urinalysis and urine culture
- creatinine and tests required for anaesthesia
- information about a stent and previous procedures
- a list of medicines and allergies
05 / After surgery
What to expect at home
Burning, frequent urges, a small amount of blood and stent-related discomfort may occur. The patient must know the removal date or plan in advance: a forgotten stent can lead to complications.
The time to resume activity and the follow-up investigation are determined by the course of surgery and kidney status.
06 / Risks
What you should know in advance
- infection and bleeding
- ureteral wall injury or subsequent narrowing
- migration of the stone into the kidney
- residual fragments
- stent symptoms
- rarely — a more serious ureteric injury
07 / Urgent care
Red flags
Fever and chills with a stone and obstructed urine drainage, no urine output, or uncontrolled pain or vomiting require emergency care. After surgery, warning signs include high fever, urinary retention, worsening pain or blood with clots.
Patient questions
Frequently asked questions
Can I wait for the stone to pass on its own?
Sometimes yes, if the chance of passage is acceptable, pain is controlled and there is no infection, significant obstruction or worsening kidney function. The decision is made after imaging and tests.
Which method of fragmentation is best?
Laser, pneumatic and ultrasonic energy serve different purposes. The choice depends on stone location and structure, the instrument and the aims of the procedure.
How long can a ureteric stent stay in?
There is no universal duration. It depends on the reason for insertion and the stent material. The treating team should give the patient a specific date or removal plan.
Verifiable evidence
Sources
This page explains general guidance in plain language. Decisions for an individual patient are made after an in-person assessment and cannot be reduced to a single guideline recommendation.
In-person assessment and a clear plan