Ureteroscopy and Laser Lithotripsy

Laser lithotripsy is used to:

• Treat stones that are too large, hard, or poorly located to be treated with shock wave lithotripsy (ESWL).
• Manage multiple stones or stones in patients who are pregnant or on blood-thinning medications.
• Remove stones in patients who have failed other non-invasive treatments.

It can provide a higher success rate than shock wave lithotripsy (ESWL) and allows for direct targeting of the stone.

The procedure is usually performed in hospital under general anaesthesia.

• A thin, flexible ureteroscope (small camera) is inserted via the urethra to locate the stone
• A laser fibre is passed through the scope to break the stone into smaller fragments
• The fragments are either removed or allowed to pass naturally
• A temporary plastic tube (ureteric stent) will be placed to help urine and fragments pass

Laser lithotripsy typically takes 1–2 hours and is usually done as day surgery. Please ensure you have arranged for someone to take you home as you will be unable to drive.

Alternative treatment options include:

• Shock wave lithotripsy (ESWL): Non-invasive, but less effective for hard or large stones
• Medical management: May be appropriate for small, asymptomatic stones

Prof Lawrentschuk will recommend the most suitable option based on the size, location, and type of stone.

You should plan to rest at home following your procedure. During this time, avoid strenuous activity, heavy lifting, and vigorous exercise. Over-the-counter painkillers can usually manage any pain.

It is common to notice some blood in the urine for 2-3 days following your procedure. It is important to drink plenty of water to ensure the stone fragments can be passed if they were not removed.

Patients also typically experience:

• Mild pain or burning when urinating for a few days.
• Urinary urgency or discomfort until the stent is removed.
• Small stone fragments visible in the urine.

These symptoms usually resolve with time. Ensure you follow all post-operative care instructions provided by your medical team/Prof Lawrentschuk. Most patients can safely resume driving 24 hours after the procedure. Return to work is generally possible within 1–2 days or whenever you feel comfortable.

• Blood in your urine (red or dark red) that lasts longer than 2-3 days.
• Fever above 38°C, chills, or severe abdominal pain and/or nausea.
• Burning when urinating that lasts longer than 1-2 days.