Concierge urology · London
Ureterorenoscopy, flexible endoscopic access to the ureter and renal pelvis for stones and upper-tract lesions.
Ureterorenoscopy (URS) uses a flexible endoscope passed via the urethra and bladder up to the ureter and renal pelvis — the standard modern approach for ureteric and renal stones, upper-tract tumours and unexplained haematuria.
Why patients choose us
- 01
The right hands
We route you to a consultant urologist who performs flexible ureterorenoscopy weekly — the person who scopes you also plans the follow-up.
- 02
Rapid stone pathway
CT KUB, consent, theatre and stent in one coordinated pathway — often within days rather than weeks.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Key facts
What ureterorenoscopy is, in short.
Six things to know before you consent — the definition, the setting, the technology, the results and how URS sits alongside CT KUB and shock-wave lithotripsy.
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Definition
Flexible endoscopic access to the ureter and renal pelvis via the urethra and bladder.
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General anaesthetic day-case
Typically performed under GA as a day-case — home the same day in most cases.
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Flexible scope with laser lithotripsy
A steerable ureteroscope carries a holmium or thulium laser fibre for stone fragmentation.
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Stone-free rate > 90% (1 session)
For ureteric and moderate renal-pelvis stones, single-session stone-free rates exceed 90%.
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Ureteric stent commonly placed post-op
A JJ stent is often left for days to weeks to protect the ureter after instrumentation.
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Complements CT KUB and shock-wave lithotripsy
URS sits alongside CT KUB imaging and ESWL — the modality depends on stone size, site and composition.
The pathway
From consultation to stent removal — what happens, in order.
One consultant urologist from consent to follow-up — coordinated across imaging, theatre and stent management.
Phase 1 · Before URS
Consultation, imaging, antibiotics
Phase 2 · On the day
GA day-case, flexible URS with laser
Phase 3 · After
Stent, follow-up, imaging
- 01
Before
Urology consultation
Consultant urologist review of symptoms, imaging and stone or haematuria history — with a clear plan and consent discussion.
- 02
Before
CT KUB
Non-contrast CT of the kidneys, ureters and bladder to size and locate the stone or lesion before theatre.
- 03
Before
Antibiotic cover
Pre-operative antibiotic prophylaxis to reduce the risk of post-URS sepsis, tailored to any prior urine cultures.
- 04
On the day
General anaesthetic
Day-case admission, consultant anaesthetist review, and general anaesthetic in the theatre suite.
- 05
On the day
Flexible URS with laser
A flexible ureteroscope is passed via the urethra and bladder up to the ureter and renal pelvis, with holmium or thulium laser lithotripsy as needed.
- 06
On the day
Stone / basket retrieval
Fragments are captured with a nitinol basket where possible; upper-tract lesions are biopsied under direct vision.
- 07
After
Post-op stent + structured plan
A JJ stent is commonly placed, with a written plan for stent removal, imaging follow-up and metabolic stone work-up.
Typical end-to-end: 1–2 weeks. Urgent stone cases: days.
What it shows
When ureterorenoscopy is the right procedure.
URS answers a specific question — what is inside the ureter and renal pelvis, and can it be treated in the same session. These are the presentations we see most.
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Ureteric stone
Direct visualisation and laser treatment of stones lodged in the ureter.
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Renal pelvis stone
Flexible URS reaches the renal pelvis and calyces for stones not suitable for ESWL.
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Upper-tract urothelial cancer
Diagnostic access, biopsy and staging of suspected upper-tract urothelial tumours.
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Ureteric stricture
Identifies and characterises narrowing of the ureter, with balloon dilatation where indicated.
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PUJ obstruction
Endoscopic assessment of pelviureteric junction obstruction alongside cross-sectional imaging.
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Haematuria source
Localises the source of unexplained upper-tract haematuria when CT and cystoscopy are inconclusive.
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Retained stent
Removal or exchange of retained or encrusted ureteric stents.
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Red flag: upper-tract urothelial tumour — nephroureterectomy pathway
Biopsy-proven upper-tract urothelial cancer usually requires nephroureterectomy — we route directly to a uro-oncology MDT.
Treatment options
What flexible URS can deliver in the same session.
The endoscope is the diagnostic and therapeutic tool — laser lithotripsy, basket retrieval, stent placement and biopsy under direct vision.
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Laser lithotripsy
Holmium or thulium laser fragmentation of ureteric and renal-pelvis stones under direct vision.
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Basket stone retrieval
Nitinol baskets capture fragments and small intact stones for extraction.
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Ureteric stent
JJ stent placement to protect the ureter after instrumentation, obstruction or injury.
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Ureteric balloon dilatation
Balloon dilatation of a ureteric stricture, typically over a guidewire.
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Endoscopic tumour ablation
Laser ablation of selected small, low-grade upper-tract urothelial tumours in kidney-sparing pathways.
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Nephroureterectomy for upper-tract cancer
Definitive surgical resection for biopsy-proven upper-tract urothelial cancer.
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Structured urology follow-up
Stent removal, repeat imaging and metabolic stone work-up on a defined timeline.
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MDT review
Uro-oncology multidisciplinary review for any suspected or confirmed upper-tract malignancy.
Our vetted London network
A small panel of urology teams, we picked them.
Consultant urologists with dedicated flexible URS practices across central London — introductions are made privately, once we understand your case.
Selection criteria
How we choose every urology team in our network.
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Consultant urologists with a dedicated stone and upper-tract endoscopy practice
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Modern flexible ureteroscopes with holmium or thulium laser platforms
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Consultant anaesthetist-led day-case pathway
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Onward uro-oncology MDT for any suspected upper-tract urothelial tumour
Red flags
When URS needs an urgent pathway — not the routine one.
Ureterorenoscopy is safe in expert hands, but a handful of situations change the pathway — sepsis, injury, cancer or a solitary kidney.
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Upper-tract urothelial tumour
Any suspicious upper-tract lesion at URS is treated as urothelial cancer until proven otherwise — MDT referral is the default.
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Post-URS sepsis
Fever, rigors or hypotension after URS is a urological emergency — antibiotics, resuscitation and drainage as needed.
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Post-URS ureteric injury / avulsion
Rare but serious — recognised intra-operatively or on early post-op imaging, and repaired urgently.
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Retained stone fragment
Residual fragments > 4 mm need a defined re-look, ESWL or repeat URS plan.
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Post-op steinstrasse
A “stone street” of fragments in the ureter after treatment — may need a stent, ESWL or repeat URS.
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Anaesthetic complication
GA-related events are uncommon but material — the consultant anaesthetist reviews risk before consent.
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Solitary kidney with stone
Obstruction in a solitary kidney is an emergency — decompression takes precedence over definitive stone treatment.
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Post-transplant kidney stone
Stones in a transplant kidney need a transplant-experienced urology team — the anatomy and access are non-standard.
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Struvite (infection) stone
Infection stones need complete clearance and prolonged antibiotics — otherwise recurrence is the rule.
Reading your report
A URS operation note can look intimidating. It isn’t.
Whatever the finding, the operation note keeps to the same four parts.
A quiet reminder
The operation note is written for your doctor, not for you — and that’s normal.
If you would like us to talk you through it before your follow-up, just ask.
- 01 Header
Indication and stone history
Your details, the indication for URS, and prior stone or upper-tract history.
- 02 Technique
Scope, laser and stent used
Which flexible ureteroscope, laser platform, basket and stent were used, with fluoroscopy time if relevant.
- 03 Findings
Stone site, size, fragmentation, mucosa
Stone location and size, fragmentation achieved, appearance of the ureteric and renal-pelvis mucosa, and any lesions biopsied.
- 04 Impression
The conclusion: read this first
Stone-free status, stent in situ, follow-up plan and any red-flag findings requiring MDT review.
Recognised by major UK insurers
Cover depends on your policy and clinic; we confirm with your insurer before booking.
Frequently asked
Everything we get asked about ureterorenoscopy.
Quick answers on anaesthetic, stents, stone-free rates, how URS compares with ESWL, and the main risks.
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What is ureterorenoscopy?
A flexible endoscopic procedure in which a steerable ureteroscope is passed via the urethra and bladder up to the ureter and renal pelvis. It is the modern standard for treating ureteric and renal stones and for accessing suspected upper-tract urothelial lesions.
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Is ureterorenoscopy done under general anaesthetic?
Yes — flexible URS is almost always performed under general anaesthetic as a day-case, allowing careful instrumentation and laser use without patient movement.
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Will I need a ureteric stent afterwards?
A JJ stent is commonly placed after URS to protect the ureter, and is usually removed after a few days to a few weeks depending on what was done.
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What is the stone-free rate after one session?
For ureteric and moderate renal-pelvis stones, single-session stone-free rates with flexible URS and laser exceed 90% in modern series.
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How does URS compare with shock-wave lithotripsy (ESWL)?
ESWL is non-invasive but has lower single-session stone-free rates and is less suitable for larger or lower-pole stones. URS is more invasive but more definitive — the choice depends on stone size, site and composition.
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What are the main risks of ureterorenoscopy?
The principal risks are urinary infection or sepsis, ureteric injury, stent-related discomfort, and, rarely, ureteric stricture. All are discussed at consent and are the reason CT KUB and antibiotic cover come first.
Sources
Guidelines and standards we used.
- European Association of Urology. Guidelines on urolithiasis and on upper-tract urothelial carcinoma.
- NICE. Renal and ureteric stones: assessment and management (NG118).
- American Urological Association. Surgical management of stones and upper-tract urothelial carcinoma guidelines.
- British Association of Urological Surgeons. Patient information and standards for ureteroscopy.
Last reviewed 2026-07-30. Next scheduled review 2027-07-30. Approx 5 min read.
Related tests
Looking for a different test?
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Ureteroscopy (rigid and flexible)
The parent procedure — rigid and flexible endoscopic access to the ureter.
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CT KUB
Non-contrast CT of the kidneys, ureters and bladder — the first-line stone scan.
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Nuclear medicine assessment of split renal function and obstruction.
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In practice, in London
Where ureterorenoscopy sits in a private London pathway
With ureterorenoscopy, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. Waiting lists on the NHS for ureterorenoscopy vary widely by borough and by how the GP letter reads. Privately in London, we can normally offer a slot inside the same week, sometimes within 48 hours if there’s a cancellation. The difference isn’t clinical quality — the consultants are frequently the same faces you’d see on the NHS — it’s the calendar.
In practice, a private ureterorenoscopy appointment in London means a named consultant, a proper hour in the room (or the equivalent on a video call), and a report you can actually read. Most of the imaging suites and endoscopy units we use sit within a mile of Harley Street or in Chelsea and Fulham, and turnaround on findings is measured in days, not weeks. For ureterorenoscopy specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
We’re careful about what a private pathway for ureterorenoscopy can and can’t promise. It can compress a wait, put you in front of a subspecialist quickly, and get a proper report in your hands within a week. It can’t rewrite what the imaging or the bloods say. Setting that expectation up front tends to make the whole experience less stressful.