Preparing for Ureteroscopy/ Retrograde intrarenal surgery

Ureteroscopy (URS) is a procedure in which an ureteroscope (flexible or rigid small camera) is inserted through the urethra (urine passage) and bladder into the ureter (tube that carries urine from kidney to bladder). Retrograde intrarenal surgery (RIRS) is a procedure for performing surgery within the kidney(s) by inserting the flexible ureteroscope into the ureter to the kidney and breaking down kidney stones with laser. 

You will be put under general anaesthesia (GA) for the surgery. The procedure usually takes 1 - 2 hours to perform. A ureteroscope will be placed into the bladder, ureter and kidney. Stones seen will be broken down with a laser energy device and the stone fragments will be removed with a special basket. The doctor, assisted by the radiographer, may use X-ray to locate the stone(s). Urine samples or tissue biopsies will be collected when indicated. At the end of the procedure, your doctor may place a temporary silicone ureteric stent to facilitate urinary flow. 

Your urologist or a member of their team will review your history and medications before the surgery and discuss with you regarding your surgery to confirm your understanding and consent for surgery. The anaesthetist will perform their final assessments before putting you under anaesthesia for the procedure. The operation lasts an average of 2 - 3 hours depending on the complexity. Most patients stay in hospital for 1 - 2 days on average.

Most of the time, the procedure can be performed as day surgery and you will be discharged after your procedure within the same day. You may experience some discomfort upon passing urine following the procedure for a few days, which can be treated with simple analgesia (painkillers). 

Fine sand-like particles or small blood clots in your urine are expected and should resolve after a couple of days. You are advised to drink more fluids than you normally would in the first 24 hours to flush your urinary system to prevent infection. 

If you have a stent inserted, you may experience discomfort in the bladder or kidney after passing urine but may occasionally persist until the stent is removed. Your doctor will arrange to remove the stent in the clinic after 2 – 4 weeks. 

Occasionally, not all the stones can be cleared within one procedure. You will be followed-up and advised for future treatment if there is recurrent or residual stone disease.