Ureterorenoscopy URS is an endoscopic procedure using a rigid or flexible ureteroscope to visualize and treat pathology in the ureter and kidney
Introduction
Ureterorenoscopy (URS) is a safe, minimally invasive, and effective procedure for removing ureteric and kidney stones without cuts or stitches. At Khan Kidney Clinic & Lithotripsy in Lahore, this procedure uses laser technology, which helps ensure quick recovery and maximum comfort.
Indications of URS Procedure
URS is recommended when:
Stones are stuck in the ureter
This is particularly true for mid or lower ureter stones that cause severe pain.
Stones not responding to medicines
This applies if painkillers, hydration, or medical expulsive therapy do not work.
ESWL lithotripsy is not suitable
This is the case for hard stones, overweight patients, or ureter blockage.
Infection due to a blocked stone
This is to quickly relieve the blockage. Recurrent stones causing pain or vomiting
2. Contraindications of URS Procedure
In case of following medical conditions URS procedure may be avoided or delayed
- Severe urinary infection (UTI) which must be treated first.
- Uncontrolled diabetes or hypertension
- Pregnancy (Procedure may only be performed in case of emergency)
- Critical bleeding and clotting disorders
How URS Procedure is Performed?
Anesthesia
You will receive general or spinal anesthesia, so that you remain comfortable and pain-free during treatment.
Ureteroscope Insertion
A thin flexible Ureteroscope will be passed through the urinary tract to reach the stone without any cut.
Stone Fragmentation
This ureteric stone will be fragmented by the urologist by using Holmium Laser or Thulium Laser to break the stone into fine dust particles.
Stone Removal
These dust particles/small fragments will be removed during the procedure by using tiny baskets.
DJ Stent Placement
After stone fragmentation and stone removal a temporary Double-J stent will be placed in the urinary tract in order to:
- Reduce pain
- Facilitate passage of remaining small fragments/gravel
- Prevent blockage
- Help smooth urine flow
The stent will be removed after 1–3 weeks.
Procedure Time for URS Procedure
- Usually this procedure is performed in 30–60 minutes
- Most patients go home the same day or next morning.
What Will You Feel After URS?
After the procedure patient may feel some of the following normal symptoms for 2–3 days:
- Mild burning in urine
- Slight blood in urine
- Heaviness in the lower abdomen
- Urinary urgency (especially if a stent is placed)
These symptoms will improve on there own or with some medicines.
Benefits of URS Procedure
- No cuts, no stitches
- High success rate (95–100%)
- Immediate stone removal
- Quick recovery
- Safe for most patients
- Works for hard stones
- Suitable for both ureteric and PUJ kidney stones
🚶♂️ URS Procedure Recovery & Aftercare
- Drink plenty of water. It will help in flushing out tiny fragments.
- Avoid heavy exercise for 7–10 days
- Take prescribed antibiotics & painkillers
- Follow-up visit for DJ stent removal (after 1–3 weeks)
3. Complications of URS Procedure
A. Intraoperative Complications
- Ureteral mucosal injury
- Ureteral perforation
- False passage creation
- Bleeding / hematuria
- Impacted stone migration (“stone retropulsion/push back”)
- Anesthesia-related complications
B. Early Postoperative Complications
- Pain / Renal colic
- Fever / UTI / Urosepsis
- Hematuria
- Stent-related symptoms:
- Dysuria
- Frequency
- Flank pain
C. Late Complications URS Procedure
- Ureteral stricture formation
- Ureteral stenosis / obstruction
- Vesicoureteral reflux (rare)
- Loss of kidney function (very rare)
4. Management of Common Complications
Ureteral Injury
- Minor mucosal injury: Place DJ stent for 2–6 weeks
- Perforation: Abort procedure → DJ stent for 4–6 weeks
- Complete avulsion: Requires ureteral reconstruction or autotransplant
Bleeding
- Usually self-limited
- Manage with hydration + rest
- Persistent bleeding → imaging + stent
UTI / Fever
- Culture-based antibiotics
- If sepsis → urgent ureteral stent or PCN for drainage
Stent-related Symptoms
- NSAIDs, alpha-blockers
- Ensure correct stent length
Why Patients Prefer URS at Lithotripsy in Lahore (Khan Kidney Clinic)?
- Advanced Laser URS
- Experienced Kidney Stone Specialist – Dr. Irfan Qadir Khan
- Safe, compassionate, and patient-centered care
- Fast recovery and stone-free results
FAQs About URS (Ureterorenoscopy)
1. What is URS (Ureterorenoscopy)?
URS is a minimally invasive procedure used to remove or break ureteric and kidney stones using a thin scope inserted through the urinary passage. No cuts or stitches are required.
2. Is URS a painful procedure?
No. URS is performed under general or spinal anesthesia, so patients remain fully comfortable and pain-free.
3. How long does the URS procedure take?
Most URS procedures take 30–60 minutes, depending on stone size and location.
4. When is URS recommended?
URS is advised for ureteric stones stuck in the ureter, stones not passing naturally, failed ESWL lithotripsy, severe pain, or infection due to blockage.
5. What type of stones can URS remove?
URS can remove ureteric stones, lower ureter stones, mid-ureter stones, and select kidney stones, especially hard stones like calcium oxalate monohydrate.
6. Is URS better than ESWL lithotripsy?
URS offers immediate stone clearance and is ideal when ESWL is not effective for hard, lower ureter, or impacted stones.
7. What is laser URS?
Laser URS uses Holmium or Thulium laser to break the stone into dust-like particles for easy removal.
8. Will I need a DJ stent after URS?
A Double-J stent may be placed temporarily to prevent blockage, reduce pain, and ensure smooth urine flow. It is removed after 1–3 weeks.
9. Is a DJ stent painful?
Some patients may feel mild discomfort, urgency, or burning, but medicines help control symptoms.
10. How long is the recovery after URS?
Most patients return home the same day or next morning and resume normal activities within 2–3 days.
11. Is there bleeding after URS?
Slight blood in urine for 1–2 days is normal and improves with hydration.
12. Can URS treat stones in both kidneys?
Yes, but usually one side is treated at a time unless medically required.
13. Are there any risks in the URS procedure?
Minor risks include:
- Mild burning
- Temporary bleeding
- Infection
- Ureteral injury (rare)
When performed by experts, URS is very safe.
14. Can children undergo URS?
Yes, URS is safe for children and commonly performed in pediatric stone cases.
15. How soon can I return to work after URS?
Most patients return to work within 24–48 hours, depending on their comfort.
16. What foods should I avoid after URS?
Avoid high salt, excessive meat, cola drinks, and dehydration. Drink plenty of water.
17. Do stones come back after URS?
Stone formation depends on diet, hydration, and metabolism. Preventive guidance helps reduce recurrence.
18. Is URS available in Lahore?
Yes, URS and laser stone removal are performed at Khan Kidney Clinic & Lithotripsy in Lahore using advanced technology.
19. How much does URS cost in Lahore?
URS cost depends on stone size, anesthesia, and hospital stay. Clinics usually offer affordable, customized packages.
20. Is URS safe for diabetic or hypertensive patients?
Yes, URS is safe if medical conditions are controlled. Doctors ensure proper medical evaluation before the procedure.