URS (For Ureteric Stone)

Symptoms of Ureteric Stones

• Sudden sharp or colicky pain in the back, side, or abdomen
• Pain radiating to the groin or genital area
• Blood in urine (hematuria)
• Painful or burning urination
• Frequent urge to urinate with little output
• Nausea and vomiting during pain episodes
• Cloudy or foul-smelling urine if infection is present
• Fever and chills in severe cases, suggesting infection

URS Procedure – Step by Step

1. Pre-Procedure Preparation

• Fasting for 6–8 hours before surgery
• Avoid aspirin and blood thinners as instructed
• Routine blood and urine tests to assess fitness and infection risk
• Imaging (CT scan/Ultrasound/X-ray) to confirm stone size and location

2. During the Procedure

• Performed under spinal or general anesthesia
• Rigid or flexible ureteroscope is inserted via urethra and bladder into the ureter
• Laser energy is used to fragment stones into smaller pieces
• Fragments are either retrieved with a basket or allowed to pass naturally
• A temporary DJ stent may be placed to keep the ureter open and reduce swelling

3. After the Procedure

• Patients are usually discharged within 24 hours
• Catheter, if placed, is removed once urine clears
• Some burning sensation, mild hematuria, or increased frequency of urination may occur temporarily
• Stone fragments may pass for up to 4–6 weeks
• Follow-up imaging may be done to check stone clearance
• Stent removal is usually scheduled within 1–2 weeks

Risks & Possible Complications

• Infection or fever after procedure
• Bleeding from the kidney or ureter
• Failure to reach or fragment very large or impacted stones (may need staged procedure)
• Ureteral injury or obstruction
• Discomfort due to temporary DJ stent

Advantages of URS

• Minimally invasive – no cuts or external scars
• High clearance rate (95–98% depending on stone type and location)
• Safe for patients unfit for open surgery
• Effective for stones resistant to ESWL (shockwave lithotripsy)
• Quick recovery with return to work within a few days
• Works well for middle and lower ureteric stones

Post-Procedure Care

• Rest at home until energy improves
• Take prescribed antibiotics and pain medication as directed
• Drink plenty of fluids to flush stone fragments
• Resume routine activities within 1–2 days unless advised otherwise
• Strain urine to collect stone fragments for analysis if instructed
• Attend follow-up visit for stent removal and imaging

Prevention of Stone Recurrence

• Stay well hydrated – aim for 2–3 liters of water daily
• Limit salt, red meat, and oxalate-rich foods (spinach, nuts, tea, chocolate)
• Maintain a healthy weight and active lifestyle
• Periodic urine and blood tests to check for metabolic causes
• Preventive medications may be prescribed in recurrent cases