Patient guide · Urology
Ureteroscopy, endoscopic access to the ureter for stones, strictures and upper-tract lesions.
Ureteroscopy is an endoscopic procedure passing a thin scope through the urethra, bladder and into the ureter — for laser stone treatment, stricture management and upper-tract urothelial tumour assessment. Same-day discharge under general anaesthetic.
Key facts
Ureteroscopy in six lines.
The essentials your urologist will assume you already know before the pre-op conversation.
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Definition
Endoscopic access to the ureter via urethra and bladder.
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Setting
Day-case under general anaesthetic.
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Scope
Rigid or flexible ureteroscope, depending on target.
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Standard treatment
Laser lithotripsy for stone fragmentation.
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Post-op
Ureteric stent commonly placed for drainage.
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Fits alongside
Complements CT KUB and shock-wave lithotripsy.
How it’s done
From urology clinic to post-op stent, in order.
One consultant urologist from first assessment to follow-up, with a structured stone-prevention plan built in.
- 01
Urology consultation
Consultant urologist assesses symptoms, imaging and prior stone history.
- 02
CT KUB
Non-contrast CT confirms stone size, position and hydronephrosis before the list.
- 03
Antibiotic cover
Prophylactic antibiotics reduce sepsis risk, especially with an infected obstructed system.
- 04
General anaesthetic
Day-case anaesthetic in lithotomy position with a full pre-op safety check.
- 05
Cystoscopy and guidewire
Cystoscope enters the bladder; a safety guidewire is passed up the ureter.
- 06
Ureteroscopy with laser
Rigid or flexible scope reaches the stone; holmium or thulium laser fragments it.
- 07
Post-op stent and plan
JJ stent placed if needed, with a structured follow-up and stone-prevention plan.
What it shows
When ureteroscopy is the right procedure.
Ureteroscopy answers a specific question — what is happening inside the ureter or upper tract, and can it be treated in the same visit.
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Ureteric stone
Direct visualisation and laser treatment of a stone in the ureter.
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Renal pelvis stone
Flexible ureteroscopy reaches stones sitting in the renal pelvis.
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Upper-tract urothelial cancer
Biopsy and staging of suspected tumours in the ureter or renal pelvis.
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Ureteric stricture
Assessment and, where appropriate, dilatation of a narrowed segment.
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PUJ obstruction
Endoscopic assessment of pelvi-ureteric junction obstruction.
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Impacted stone
Definitive treatment when a stone has failed to pass or is stuck.
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Haematuria source
Direct upper-tract inspection when the source of bleeding is unclear.
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Red flag: impacted stone + sepsis — emergency stent
A septic obstructed kidney is an emergency — decompression before definitive treatment.
Treatment options
What ureteroscopy can do — and where it hands over.
Most stone and upper-tract work is treated at the same sitting; some findings hand off to a wider urology or oncology pathway.
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Laser lithotripsy
Holmium or thulium laser fragments the stone into passable pieces or dust.
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Basket stone retrieval
A nitinol basket removes intact fragments or a small whole stone.
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Ureteric stent
A JJ stent keeps the ureter draining while any oedema settles.
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Ureteric balloon dilatation
A balloon opens a tight stricture or a narrowed segment for scope passage.
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Endoscopic tumour ablation
Selected upper-tract tumours are treated endoscopically with laser.
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Nephroureterectomy
Open, laparoscopic or robotic removal when upper-tract cancer needs radical treatment.
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Structured urology follow-up
Post-op review with imaging, stone analysis and metabolic work-up.
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MDT review
Multi-disciplinary team review for tumours or complex recurrent stone disease.
Red flags
When ureteroscopy needs a higher level of caution.
These are the situations that change consent, timing or the type of scope used — and where the anaesthetic and post-op plan is stricter.
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Impacted stone with sepsis — emergency decompression before definitive treatment.
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Ureteric avulsion — rare but serious intra-operative complication needing reconstruction.
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Ureteric perforation — usually managed with stenting and antibiotic cover.
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Retained stone fragment — planned second-look ureteroscopy or repeat treatment.
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Post-op steinstrasse — a column of fragments blocking the ureter after treatment.
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Anaesthetic complication — assessed and managed by the anaesthetic team.
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Solitary kidney with stone — lower reserve; treatment planning is stricter.
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Post-transplant kidney stone — specialist input and careful access planning.
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Upper-tract urothelial tumour — staging and MDT review before definitive treatment.
Frequently asked
Everything we get asked about ureteroscopy.
Anaesthetic, laser treatment, stents, and how ureteroscopy compares with shock-wave lithotripsy.
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What is a ureteroscopy?
A ureteroscopy is an endoscopic procedure where a thin telescope is passed through the urethra and bladder into the ureter, and often up to the kidney. It is used to see, biopsy and treat stones, strictures and upper-tract tumours.
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Is ureteroscopy done under general anaesthetic?
Yes — in the UK it is nearly always performed under a general anaesthetic as a day-case, so you go home the same day in most instances.
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What is laser lithotripsy?
Laser lithotripsy uses a holmium or thulium laser fibre passed down the ureteroscope to fragment a stone into small pieces or dust that can pass, or be removed with a basket.
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Will I need a ureteric stent afterwards?
A JJ stent is commonly placed after ureteroscopy to keep the ureter draining while any swelling settles. It is usually removed in clinic one to two weeks later.
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How is ureteroscopy different from shock-wave lithotripsy?
Shock-wave lithotripsy fragments stones from outside the body with focused sound waves. Ureteroscopy treats the stone directly through a scope, and is generally preferred for impacted, lower ureteric or larger stones.
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What are the main risks?
The main risks are urinary infection or sepsis, ureteric injury or perforation, stent-related discomfort, retained fragments and — rarely — ureteric avulsion. Your urologist will discuss these in detail before consent.
Sources
Reviewed against current guidance.
- European Association of Urology — urolithiasis and upper-tract guidelines.
- NICE. Renal and ureteric stones: assessment and management (NG118).
- American Urological Association — surgical management of stones and upper-tract disease.
- British Association of Urological Surgeons — patient information and standards.
Published 2026-07-30 · Last reviewed 2026-07-30 · Next review 2027-07-30 · About a 5-minute read.
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In practice, in London
How ureteroscopy tends to unfold when you go private
With ureteroscopy, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. On the NHS, ureteroscopy typically sits behind a triage step and a wait that can stretch from a few weeks into months. In London’s private sector, the same appointment often lands within days. That speed matters when symptoms are disrupting work, sleep, or a plan you’d already committed to — and it’s the single most common reason people call us in the first place.
In practice, a private ureteroscopy 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 ureteroscopy specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
Where a good concierge earns its keep is in the matching. There are dozens of consultants in London who see ureteroscopy — but not all of them are the right fit for every case. We narrow it down based on subspecialty, insurer coverage, the specific question being asked, and whether continuity into treatment matters. The right first appointment saves you from repeating yourself later.