Patient guide · Urology
Ureteroscopy (rigid and flexible), endoscopic access to the ureter — rigid for lower ureter, flexible for upper tract.
Ureteroscopy uses either a rigid scope (lower ureter, larger channel, faster) or a flexible scope (upper ureter and renal pelvis) — depending on stone location, ureter anatomy and surgical goal. Choice made by the urologist at consultation.
Why patients choose us
- 01
The right hands
A consultant urologist with a stone-disease practice — the operator who scopes you decides the answer.
- 02
Often answers same-day
Findings are discussed with you as soon as anaesthetic wears off, with the written report to follow.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Key facts
Ureteroscopy at a glance.
The six things worth knowing before you scroll further — definition, anaesthetic, scope choice, laser lithotripsy and the role of the JJ stent.
- 01
Definition
Endoscopic access to the ureter and renal pelvis, performed by a consultant urologist.
- 02
General anaesthetic day-case
Performed under general anaesthetic as a day-case — home the same day in most cases.
- 03
Rigid scope for lower ureter
Rigid ureteroscope for lower-ureteric stones — larger channel, faster access, robust irrigation.
- 04
Flexible scope for upper tract
Flexible ureterorenoscope for upper ureter and renal pelvis — deflectable tip reaches every calyx.
- 05
Laser lithotripsy standard
Holmium or thulium fibre laser fragments stones under direct vision at the same session.
- 06
Ureteric stent often placed
A JJ stent is commonly placed post-procedure to protect the ureter and ease drainage.
Preparation and pathway
From consultation to report — what happens, in order.
One consultant urologist from first appointment to structured report — including anaesthetic assessment, imaging and stent planning.
Phase 1 · Before theatre
Consultation, imaging, antibiotics
Phase 2 · On the day
Anaesthetic, access, ureteroscopy
Phase 3 · After
Stent, report and follow-up
- 01
Before
Urology consultation
A consultant urologist reviews symptoms, prior imaging and blood tests, and confirms ureteroscopy is the right step.
- 02
Before
CT KUB
Non-contrast CT of the kidneys, ureters and bladder — the gold-standard imaging for stone size, position and density.
- 03
Before
Antibiotic cover
Prophylactic antibiotics per local protocol — critical if urine culture shows any infection.
- 04
On the day
General anaesthetic
Anaesthetic assessment, then general anaesthetic in a day-case theatre setting.
- 05
On the day
Cystoscopy + guidewire
Cystoscopy to identify the ureteric orifice, followed by a safety guidewire up the ureter.
- 06
On the day
Rigid or flexible URS
Rigid ureteroscope for lower-ureteric work, or flexible ureterorenoscope for upper-tract access — with laser lithotripsy or basket retrieval as needed.
- 07
After
Post-op stent + structured plan
JJ stent placed where indicated, with a structured written plan for stent removal, imaging follow-up and metabolic work-up.
Typical end-to-end: 1–2 weeks. Urgent cases (impacted stone with sepsis): same day.
What it shows
What ureteroscopy can find, and treat, in one visit.
The presentations ureteroscopy is designed for — with the red-flag pathway (impacted stone plus sepsis) called out separately.
-
Ureteric stone (lower / mid / upper)
Stones at any level of the ureter — the operator selects rigid or flexible scope based on position.
-
Renal pelvis stone
Stones sitting in the renal pelvis or calyces — accessed with the flexible ureterorenoscope.
-
Upper-tract urothelial cancer
Direct visualisation and biopsy of suspicious lesions in the ureter or renal pelvis.
-
Ureteric stricture
Narrowing of the ureter identified, characterised and dilated at the same session where possible.
-
Impacted stone
A stone stuck in the ureter — laser fragmentation and basket retrieval under direct vision.
-
Ureteric injury
Iatrogenic or traumatic ureteric injury identified endoscopically, with stent placement.
-
Retained stent
Encrusted or forgotten JJ stents retrieved endoscopically, with any residual stone treated.
-
Red flag: impacted stone with sepsis — emergency stent
Obstructed, infected system is a urological emergency — emergency stent or nephrostomy takes priority over stone treatment.
Next steps
What happens after the ureteroscopy.
The eight most common next steps — from laser lithotripsy and basket retrieval to balloon dilatation, tumour ablation, nephroureterectomy and structured follow-up.
-
Laser lithotripsy
Holmium or thulium fibre laser fragments the stone into dust and small fragments under direct vision.
-
Basket retrieval
Nitinol tipless basket to retrieve stone fragments intact for histology or complete clearance.
-
Ureteric stent
JJ stent to protect the ureter, ease drainage and reduce post-op colic — removed at 1–2 weeks.
-
Ureteric balloon dilatation
Balloon dilatation of ureteric strictures to restore drainage and access.
-
Endoscopic tumour ablation
Laser ablation of low-grade upper-tract urothelial tumours in selected cases — kidney-sparing option.
-
Nephroureterectomy
Surgical removal of kidney and ureter for high-grade or invasive upper-tract cancer — MDT decision.
-
Structured urology follow-up
Post-op imaging, stent removal, metabolic screen and dietary advice to reduce recurrence risk.
-
MDT review
Multidisciplinary team review for cancer, complex stone burden or recurrent disease.
Red flags
When ureteroscopy shouldn’t wait — or needs extra caution.
The nine situations that raise the stakes — from obstruction with sepsis to solitary kidneys and struvite stones.
-
Impacted stone + sepsis
Obstruction plus infection is a urological emergency — decompression with stent or nephrostomy comes first, stone treatment later.
-
Ureteric avulsion
A rare but serious complication requiring immediate surgical repair — recognised intra-operatively.
-
Ureteric perforation
Perforation during scope passage or lithotripsy — managed with prolonged stenting and close follow-up.
-
Retained fragment
Residual stone fragment after lithotripsy — repeat URS or ESWL may be needed for full clearance.
-
Post-op steinstrasse
A column of fragments obstructing the ureter after lithotripsy — requires urgent decompression.
-
Anaesthetic complication
General anaesthetic carries a small risk of respiratory, cardiac or allergic complication — pre-op assessment mitigates this.
-
Solitary kidney
Any procedure on a solitary kidney demands extra caution — stent threshold is lower, follow-up tighter.
-
Post-transplant kidney
Ureteroscopy in a transplant kidney is a specialist procedure — coordinated with the transplant team.
-
Struvite (infection) stone
Infection stones seed sepsis — culture-directed antibiotics and complete stone clearance are essential.
Reading your report
A ureteroscopy report can look intimidating. It isn’t.
Whatever the finding, the report keeps to the same four parts.
A quiet reminder
The report 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 scope selection
Your details, the reason for ureteroscopy, and whether a rigid or flexible scope (or both) was used.
- 02 Technique
Anaesthetic, access and instruments
Anaesthetic used, cystoscopic access, guidewire placement, ureteric access sheath if any, and laser or basket instruments deployed.
- 03 Findings
Stone or lesion description
Position, size and appearance of stone or lesion, fragmentation achieved, any biopsies taken, and stent placement.
- 04 Impression
The conclusion — read this first
Result, stent status, and the concrete next step — stent removal, imaging follow-up, metabolic screen or MDT referral.
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 ureteroscopy.
Quick answers on rigid vs flexible, anaesthetic, JJ stents, results and risks.
-
What is ureteroscopy?
Ureteroscopy is an endoscopic examination of the ureter — the tube between kidney and bladder. A rigid scope is used for the lower ureter, while a flexible scope reaches the upper ureter and renal pelvis. It is the mainstay treatment for ureteric and small renal stones, and is also used to biopsy or ablate upper-tract urothelial tumours.
-
What is the difference between rigid and flexible ureteroscopy?
A rigid ureteroscope is a straight metal scope with a large working channel — ideal for the lower ureter, where robust irrigation and fast fragmentation matter. A flexible ureterorenoscope has a deflectable tip that navigates the curves of the upper ureter and every calyx of the kidney. The urologist chooses at consultation based on stone position and anatomy.
-
Do I need a general anaesthetic?
Yes, in almost every case. Ureteroscopy needs the ureter to be completely still and the patient completely relaxed — general anaesthetic (or occasionally spinal) is standard. You will have a pre-op anaesthetic assessment.
-
Will I need a ureteric stent afterwards?
Often, yes. A JJ stent (a soft plastic tube from kidney to bladder) protects the ureter, eases drainage and reduces post-op renal colic. It is removed at 1–2 weeks in clinic, usually under local anaesthetic. Stents can cause bladder discomfort — we brief you fully before the procedure.
-
How quickly will I get results?
Verbal findings are discussed with you as soon as anaesthetic wears off. A structured written report follows within 48 hours. If biopsies were taken, histology typically returns within one to two weeks.
-
What are the risks?
Ureteroscopy is a well-established procedure but carries small risks: urinary tract infection, ureteric injury (perforation or, rarely, avulsion), residual stone fragments, stent discomfort, and general anaesthetic risks. The consultant urologist will discuss these in detail at consultation.
Sources
The guidance behind this guide.
- European Association of Urology. Guidelines on urolithiasis.
- NICE. Renal and ureteric stones: assessment and management (NG118).
- American Urological Association. Surgical management of stones guideline.
- British Association of Urological Surgeons. Ureteroscopy patient information.
Reviewed 2026-07-30 by Pulse Atlas Editorial Board, . Next review 2027-07-30. Estimated reading time 5 minutes.
Related tests
Looking for a different test?
-
Ureterorenoscopy
The flexible ureterorenoscopy pathway in more detail.
Learn more -
CT KUB
Non-contrast CT of kidneys, ureters and bladder for stones.
Learn more -
Renogram scan
Functional imaging of the kidneys and drainage.
Learn more -
All tests
Browse every test and procedure we arrange.
Learn more -
Prostate Enlargement BPH
Related condition guide.
Learn more -
Kidney Disease CKD
Related condition guide.
Learn more -
Cystectomy
Related treatment option.
Learn more -
Cystoplasty
Related treatment option.
Learn more
In practice, in London
Where ureteroscopy rigid and flexible sits in a private London pathway
With ureteroscopy rigid and flexible, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. The NHS route for ureteroscopy rigid and flexible is thorough, but the queue is real. Most patients we speak with have been told to expect anywhere from a handful of weeks to several months, depending on their local trust and how the referral is graded. Going private in London usually collapses that window to a matter of days — often the same week if the diary allows. It isn’t about jumping a queue so much as buying time back while you still have the flexibility to plan around it.
Once you’re in the private system for ureteroscopy rigid and flexible, the pace picks up noticeably. Consultant slots run to time, imaging is usually available in the same building or a short walk away, and the report comes back typed and detailed. It’s the coordination that tends to feel different — one person on the other end of the phone, not a switchboard. For ureteroscopy rigid and flexible 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 ureteroscopy rigid and flexible 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.
Nearby in the library