Ureteroscopy with/without a Stent

What is a ureteroscopy?

This is a procedure that allows your doctor to see the inside of your bladder, ureters (tubes that carry urine from you kidneys to the bladder) and the inside of your kidneys. It is done by a urologist—a surgeon who specializes in problems with the urinary system.

A ureteroscope, is a very long, thin camera that lets the urologist see inside different parts of your urinary tract. During this procedure, you are completely asleep under anesthesia. The ureteroscope is carefully threaded up your urethra (the tube that allows you to pass urine), into your bladder, and then into the lower part of either your left or right ureter (the tubes that connect the kidneys to your bladder).

Why do I need a ureteroscopy?

Most often, ureteroscopy is done to treat kidney stones, but it can also be done for other reasons, such as infection, tumor, or blood in the urine. If you have kidney stones that have become stuck in your ureter, the doctor can use a basket on the end of the ureteroscope to collect the stone. If the stone is too large for the basket, the stone can be broken into small pieces using a laser that can then pass in your urine. To help pass the stone, the urologist may place a ureteral stent in the ureter.

What is a ureteral stent?

A ureteral stent is a soft, thin tube that holds the ureter open and makes it easier for the stones to pass from the kidney into the bladder. Stents are also used to treat other causes of blockage in your urinary tract like blood clots, tumors, scar tissue, and ureteropelvic junction obstruction (narrowing of the ureter). If left untreated, ureteral obstruction can cause kidney damage over time. Most stents are temporary, but some people may need them for a longer time. They can stay in your ureter for three to six months before they need to be removed or exchanged.

The type of stent you have will depend on how long the doctor thinks you need it. Stents that are temporary (several days) will have a string attached. This string hangs out of your urethra. The stent can be removed by the doctor during an office visit by gently pulling on the string. Patients can remove the stent at home if they are comfortable doing this. If this is the case for you, you will be given instructions on how to remove it. Do not remove the stent yourself unless you have been told it is ok by your doctor. You can urinate, have bowel movements and shower normally. The string will be secured to your inner thigh or pubic area with medical tape.

If the stent needs to stay in for longer than a few days, it will not have a string. This type of stent is removed in the office by passing a small camera (cystoscope) into the bladder. This procedure is very brief and is performed awake with local anesthetic inside your urethra.

What should I expect during a ureteroscopy?

This procedure is usually done with general anesthesia, but before the procedure, your anesthesiologist will discuss the anesthesia plan that is best to make sure you are safe and comfortable during the procedure.

After the ureteroscopy

  • You will remain in a recovery area to allow the effects of the anesthesia medicine to wear off. You will need a responsible person to drive you home and stay with you for 24 hours.
  • If you take blood thinning medication and were asked to not take it before the procedure, be sure you know when you can start taking it again after the procedure.
  • You can expect to see blood in your urine. This can look red, bright pink and have clots in the urine or on toilet tissue and may last for several days after the procedure.
  • Your urethra may be sore, you may feel a burning sensation when you pee, or you may have more frequent urination than usual. These things are normal and will get better in 1 - 2 weeks.
  • Rest when you feel tired. Getting enough sleep will help you recover.
  • It is ok to resume work and your usual exercise routine 24 hours after surgery
  • Some people have difficulty starting their urine stream after the procedure. This is called “urinary retention” and can be a problem if it lasts for longer than 8 hours after your procedure. To help prevent/relieve urinary retention:
    • Walk! Walking helps “wake up” the nerves in your bladder that send signals to your body, telling you your bladder is full. After you are fully awake in the recovery room, ask for help walking to the bathroom, even if you don’t feel the urge to void.
    • Turn on the faucet. Listening to the sound of running water can help start your urine stream.
    • Place a warm pack on your suprapubic area (the space just above your genitals, below your belly).
    • Take a warm bath at home if someone is there to help you. DO NOT use bubble bath, oils, or salts. A warm bath is a good way to relax the muscles and aid in urination. If you aren’t able to get in a bath, sitting on the toilet and running warm water over your genitals can also stimulate the urge to pee.
    • Be sure you are getting enough to drink. You won’t feel the urge to pee if your bladder is empty.

How to ease post-procedural symptoms

  • Placing a warm, damp washcloth on the opening of your urethra, repeating as needed, can ease some of the soreness from the procedure.
  • Drink plenty of water (unless you are on a fluid restriction for another condition) to flush irritants out of your bladder. Try to drink at least 8 ounces of water every 1-2 hours while you are awake for the first day or two after your procedure.
  • If you were prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. Most patients do not require antibiotics after this procedure.
  • Place a warm pack on your flank (the area on your back, to the side and just below your lower ribs and hips).
  • Most people do well by managing their pain with over-the-counter pain relievers.

If you have a urinary stent:

  • You may have a thin string coming out of your urethra. This string is attached to the stent. Try not to pull on the string. It will be used to pull out the stent when you no longer need it.
  • You may notice blood in your urine until the stent is removed. This is normal.
  • You may be prescribed medicine for bladder spasms. Take this as directed.
  • Most people are able to return to work a day or two after the stent is placed. If your work requires intense physical activity, you may feel pain in your kidney area (in your back, just below your ribs). If this happens, you may need to reduce your activity until the stent is removed.
  • Call NL Urology at 207-947-0469 if part or all of the stent comes out of your urethra.

A doctor is available 24 hours a day to help with urgent matters you may have after this procedure. Call the NL Urology office at 207-947-0469 if:

  • You have trouble passing urine or stool, especially if you have pain in your lower belly.
  • You develop nausea, fever, severe chills, or body aches.
  • Your bleeding is increasing, instead of decreasing, after 3 days.
  • Your urine is dark red, or you see large clots (larger than a quarter) in your urine.
  • You have other, urgent symptoms you think may be related to the procedure and need to speak with a doctor.
  • You experience new or worsening symptoms.

Seek immediate medical attention if:

  • You have severe trouble breathing
  • You have sudden chest pain and shortness of breath, or you cough up blood
  • You have severe belly pain

There is more to know about having a procedure at Northern Light Eastern Maine Medical Center!

To find out how to prepare and what to expect at on the day of your procedure, including information about having and recovering from anesthesia, please click here