Urology · London
Private holmium (Ho:YAG) laser treatment in London, by a consultant urologist.
The workhorse laser of UK endourology - for kidney and ureteric stones, bladder stones, upper tract tumours, ureteric strictures and en-bloc bladder tumour resection. Day-case, consultant-led.
Indicative pricing
What private holmium laser treatment costs in London.
Indicative ranges across UK private providers.
In short
£3,500–£6,500, home the same day.
| Procedure | Indicative range | Typical duration | Stay |
|---|---|---|---|
| URS + Ho:YAG laser lithotripsy (ureteric stone) | £3,500–£6,500 | 45–75 min | Same day |
| Flexible URS + laser (renal stone) | £4,500–£8,000 | 60–90 min | Same day |
| Mini-PCNL + Ho:YAG (larger renal stones) | £8,000–£14,000 | 90–120 min | 1–2 nights |
| Endoscopic laser ablation (upper tract tumour) | £5,500–£9,500 | 60–90 min | Same day |
| Bladder stone laser fragmentation | £3,000–£5,500 | 30–60 min | Same day |
| Ureteric stricture endoureterotomy | £3,500–£6,500 | 45–75 min | Same day |
| En-bloc bladder tumour resection (ERBT) | £4,500–£8,000 | 60–90 min | Same day |
| Consultation only | £200–£400 | 30 min | Same visit |
Prices vary by clinic, by which urologist does the case, by stone burden, and by whether a ureteric access sheath, mini-PCNL tract or second-look procedure is needed.
The problem
The right laser, the right operator, the right plan.
Endourology is a fast-moving field - Moses fibres, thulium fibre lasers, single-use scopes. The kit only matters if the operator uses it well, and the plan afterwards is clear.
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Not sure it is needed?
For some smaller stones, shockwave lithotripsy or watchful waiting is smarter. We say so before you book theatre time.
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Worried about the stent?
The stent is the part patients most dread. We plan removal timing up front and give you the stent-symptoms leaflet before the day.
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Want it done properly?
A named consultant urologist with a dedicated stone practice, a proper theatre, and follow-up imaging booked before you leave.
When it helps
When holmium laser treatment is the right step.
The situations we see most, plus the one red flag that means an emergency rather than an appointment.
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Ureteric stone > 10 mm
NICE NG118 favours ureteroscopy with laser lithotripsy over shockwave for larger ureteric stones or when SWL has failed.
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Renal stone > 10 mm or lower pole > 5 mm
Flexible ureteroscopy with Ho:YAG fragments and dusts stones in any pole - including cystine stones that resist shockwave.
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Obstructed, infected stone
A stone blocking the kidney with a fever is a urological emergency - urgent decompression first, definitive laser lithotripsy after.
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Upper tract urothelial cancer
Selected grade 1–2, unifocal, small (< 15 mm) tumours can be treated endoscopically with laser ablation - kidney-sparing.
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Bladder stones
Fragmented and cleared endoscopically at the same sitting - quicker recovery than open bladder surgery.
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Ureteric stricture
A narrowed segment of ureter can be incised (endoureterotomy) with the holmium laser, avoiding open reconstruction in selected cases.
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Bladder tumour (ERBT)
En-bloc laser resection of a bladder tumour - a precise alternative to conventional TURBT in appropriate cases.
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Red flag: sepsis with obstruction
Fever, flank pain and known stone is a same-day A&E presentation, not a clinic booking - decompression cannot wait.
Procedure options
The holmium laser wears many hats.
What each application actually involves - and which fits which problem.
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Flexible ureteroscopy + Ho:YAG
The workhorse for renal and ureteric stones. Scope up through the bladder and ureter, laser the stone, basket the big fragments, stent.
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Rigid/semi-rigid URS + Ho:YAG
For lower ureteric stones. Shorter, stiffer scope, same laser principles.
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Mini-PCNL + Ho:YAG
A small tract through the flank into the kidney for larger stone burdens - usually an overnight stay.
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Endoscopic laser tumour ablation
Kidney-sparing treatment for small, low-grade upper tract urothelial cancers in selected patients (BAUS/EAU guidance).
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En-bloc bladder tumour resection
ERBT with the holmium laser - removes the tumour in one piece for cleaner pathology than piecemeal TURBT.
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Endoureterotomy
A precise laser incision through a short ureteric stricture - day-case, stent-covered, no external scars.
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Bladder stone lithotripsy
Fragmentation and clearance of bladder stones under GA - often combined with treatment of the underlying cause (BPH, catheter, diverticulum).
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Thulium fibre laser (TFL)
A newer rival to Ho:YAG with a finer beam and less retropulsion. Some UK centres now offer it - we tell you if it suits your case.
Safety and recovery
What to expect afterwards - honestly.
Holmium laser endourology is a common, safe day-case procedure. The things worth planning are the stent, infection risk in obstructed systems, and knowing what is normal after.
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Almost always general anaesthetic
Ureteroscopy is uncomfortable awake and needs a still patient for laser work. GA is standard; sedation is occasional for very short cases.
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The ureteric stent, and its symptoms
Most patients wake up with a stent (a soft plastic tube kidney-to-bladder). Expect frequency, urgency, flank ache with voiding, and some blood in urine while it is in.
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Stent removal is quick
Removed in outpatients under local anaesthetic - a brief flexible cystoscopy, usually a few minutes.
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Ureteric injury is uncommon
Perforation happens in around 1–2% of cases and usually heals with a stent alone. Ureteric avulsion (a serious injury) is very rare in expert hands.
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Infection risk is real
UTI in 5–10% and sepsis in 1–3% - higher if the kidney was obstructed. Antibiotic cover is routine and urine is checked pre-op.
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Retained fragments happen
Not every case is stone-free at one sitting, especially for larger stones. A second ureteroscopy is occasionally needed.
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Long-term stricture is rare
A narrowed ureter after healing is uncommon (< 1%) but is a recognised risk - worth knowing about, especially with repeat procedures.
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Return to work
Most patients are back at desk work within a few days. Heavy lifting waits until the stent is out.
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Red flags after discharge
Fever, rigors, heavy bleeding or worsening flank pain need same-day medical review - call the clinic or A&E.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever indication was treated, the note the urologist sends you keeps to the same shape.
A quiet reminder
Endourology language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication and laser used
Why the procedure was done - stone, tumour, stricture - and which laser (Ho:YAG, TFL) and settings were used.
- 02 Technique
Access, scope and fibre
Whether flexible or rigid ureteroscopy, tract for PCNL, fibre calibre (200–365 micron), and whether a ureteric access sheath was used.
- 03 Findings
Stone burden, clearance, complications
Stone size and location, how much was fragmented, whether all visible fragments were basketed, and any intra-operative issues.
- 04 Impression
Stent plan, follow-up imaging, review
Read this first: how long the stent stays in, when it is removed, when the follow-up CT KUB is booked, and whether metabolic stone workup is planned.
Recognised by major UK insurers
Cover for holmium laser endourology is standard when medically indicated - stones, tumours, strictures.
Frequently asked
Everything we get asked about holmium laser treatment.
Quick answers on how it compares to shockwave, what the stent is like, what it costs, and when to worry.
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What is a holmium (Ho:YAG) laser and why is it used?
Ho:YAG is a 2100 nm pulsed laser that is strongly absorbed by water, which makes it superb at fragmenting kidney stones and cutting through soft tissue with very little thermal spread to nearby structures. It is the workhorse laser of UK endourology and also treats bladder stones, upper tract tumours, ureteric strictures and bladder tumours.
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How does holmium laser lithotripsy compare to shockwave (SWL)?
NICE NG118 favours ureteroscopy with laser for ureteric stones over 10 mm and renal stones over 10 mm (or lower pole over 5 mm). Laser works on all stone compositions - including cystine, which shockwave often fails to break - and is much less affected by patient body habitus. SWL still has a role for smaller, favourably placed stones.
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What is the Moses effect?
A pulse-modulation technology that shapes the holmium pulse so it travels through a "vapour tunnel" in the irrigation fluid before hitting the stone. It reduces retropulsion (the stone being pushed away from the laser), which means quicker fragmentation and better dusting.
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What is the thulium fibre laser (TFL) and should I have it instead?
TFL is a newer 1940 nm laser with a finer beam, less retropulsion and excellent dusting. UK adoption is growing and evidence is comparable or better than Ho:YAG for many stone cases. Availability is patchy; we tell you when a centre offers it and whether it fits your case.
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How much does private holmium laser stone treatment cost in London?
Roughly £3,500–£6,500 for a straightforward ureteroscopy and laser lithotripsy, £4,500–£8,000 for a more complex flexible URS on a renal stone, and £8,000–£14,000 for mini-PCNL.
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Why do I need a stent afterwards and what does it feel like?
A ureteric stent keeps the ureter open while it settles from any swelling, and drains the kidney if fragments are still passing. Expect frequency, urgency, a mild flank ache when you pass urine, and some blood in the urine - all normal while it is in. It is removed in outpatients under local anaesthetic.
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How long is the recovery?
Most patients are back to office work within a few days. Heavy lifting, cycling and the gym wait until the stent is out (typically one to four weeks). Full return to normal, including any second-look procedure if needed, is usually within six weeks.
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When should I go to A&E rather than book a clinic appointment?
Flank pain with a fever or shaking chills after a known stone, heavy bleeding after the procedure, or being unable to pass urine at all - all reasons to go to A&E the same day rather than wait for a clinic slot.