URS for Kidney Stones: Procedure, Benefits, Risks and Recovery

Kidney stones can cause severe pain, blood in the urine, urinary blockage, and infection. While some small stones pass naturally, others remain stuck in the ureter and require medical treatment. When a stone does not pass or causes complications, our urologist may recommend a procedure called ureteroscopy (URS).

URS is a minimally invasive procedure that allows the doctor to locate and remove or break kidney and ureteric stones without making an incision in the skin. Our urologist passes a thin instrument called a ureteroscope through the urinary passage to reach the stone. The doctor may then use a laser to break the stone into smaller fragments or remove it with a small basket.

At Jyoti Hospital, Gurugram, our urology team evaluates patients with kidney and ureteric stones and recommends suitable treatment based on stone size, location, symptoms, and kidney function.

What Is URS (Ureteroscopy) for Kidney Stones?

Ureteroscopy, commonly called URS, is a minimally invasive procedure that helps doctors diagnose and treat stones inside the ureter and, in selected cases, the kidney.

The ureter is a narrow tube that carries urine from each kidney to the bladder. A stone can become stuck inside this tube and block urine flow, causing severe pain and swelling of the kidney.

During URS, our urologist passes a thin telescope-like instrument through the urethra, into the bladder, and then into the ureter. The instrument has a camera and light that help the doctor see the stone.

Our doctor use small instruments to remove the stone or a laser to break it into smaller pieces.

Important features of URS include:

• The procedure does not require an incision in the skin.
• Our urologist reaches the stone through the natural urinary passage.
• The doctor can treat selected ureteric and kidney stones.
• The doctor may use a laser to break the stone.
• The patient may need a temporary ureteric stent after the procedure.

Our doctors generally perform URS under general or spinal anaesthesia, depending on the patient’s condition and the planned procedure.

When Does a Doctor Recommend URS for Kidney Stones?

Not every kidney stone requires surgery. Small stones may pass naturally, while some patients can manage their symptoms with medicines and regular monitoring.

However, our urologist may recommend URS when a stone needs active removal.

Common reasons include:

1. A Kidney Stone Does Not Pass Naturally

Some ureteric stones remain stuck despite observation and medical treatment. If the stone has a low chance of passing naturally, your doctor may recommend URS.

2. Severe or Repeated Kidney Stone Pain

A stone can cause repeated episodes of severe pain when it blocks or irritates the ureter. If suitable medicines do not control the pain, our doctor may recommend stone removal.

3. Urinary Obstruction

A stone can block urine flow from the kidney to the bladder. Continued obstruction can cause swelling of the kidney, a condition called hydronephrosis.

Our urologist may recommend URS or another suitable procedure to remove the blockage.

4. A Stone in the Ureter

URS commonly treats stones located in the upper, middle, or lower ureter. The doctor can reach the stone through the urinary passage and remove or break it.

5. Selected Kidney Stones

A flexible ureteroscope can also reach stones inside the kidney. Doctors commonly call this approach retrograde intrarenal surgery (RIRS).

Our urologist selects a rigid, semi-rigid, or flexible instrument according to the stone’s location and the treatment plan.

6. Repeated Urinary Problems

Some patients experience recurring urinary symptoms, pain, or obstruction because of a stone. Our doctor may recommend URS after evaluating the scan findings and overall condition.

Important: Fever or chills with an obstructing kidney stone may indicate an infected urinary blockage. This condition requires urgent medical treatment. Doctors usually treat the infection and drain the blocked urinary system before considering definitive stone removal.

What Size Kidney Stone Requires URS?

Stone size helps our doctor choose the right treatment, but no single size automatically means that every patient needs URS.

Our urologist considers the stone’s location, number, density, symptoms, and effect on kidney function.

The following table provides general guidance.

Stone size	Possible treatment approach
Less than 5 mm	Many stones pass naturally; URS is usually unnecessary unless complications develop
5–10 mm	Observation, medicines, ESWL, or URS may suit selected patients
10–20 mm	URS, RIRS, ESWL, or another procedure may be considered depending on location
More than 20 mm	PCNL often serves as the preferred treatment for larger kidney stones; selected cases may require other approaches

These categories are not fixed treatment rules. A 6 mm ureteric stone that causes persistent obstruction may need treatment, while a larger stone inside the kidney may not require immediate intervention if it causes no symptoms or complications.

Our urologist reviews imaging reports and other test results before recommending URS or another stone-removal procedure.

What Is the Difference Between URS and RIRS?

Patients often hear the terms URS and RIRS during a kidney stone consultation. Both procedures use instruments passed through the urinary passage, but doctors commonly use them for different stone locations.

URS (Ureteroscopy): Our urologist uses a ureteroscope to reach and treat stones inside the ureter.

RIRS (Retrograde Intrarenal Surgery): Our urologist uses a flexible ureteroscope to reach stones inside the kidney and treat them with a laser.

Feature	URS	RIRS
Full name	Ureteroscopy	Retrograde Intrarenal Surgery
Main treatment area	Ureter	Kidney
Instrument	Rigid, semi-rigid, or flexible ureteroscope	Flexible ureteroscope
Stone location	Upper, middle, or lower ureter	Inside the kidney
Laser use	Yes, when required	Yes
Skin incision	No	No

The terms can overlap because flexible ureteroscopy can reach both the ureter and kidney. Our doctor chooses the technique based on the stone’s exact location and the treatment required.

How Is URS for Kidney Stones Performed?

The URS procedure usually takes place in an operating room under anaesthesia. The exact steps depend on the stone’s location, size, and complexity.

Our urologist explains the planned procedure and answers your questions before surgery.

Step 1: Anaesthesia

Our anaesthesiologist evaluates your health and decides which type of anaesthesia suits you.

Doctors commonly use:

• General anaesthesia: You remain asleep during the procedure.
• Spinal anaesthesia: The doctor numbs the lower part of your body so you do not feel pain during surgery.

The anaesthesiologist monitors your vital signs throughout the procedure.

Step 2: Inserting the Ureteroscope

Our urologist gently passes a thin ureteroscope through the urethra and bladder into the ureter.

The instrument contains a camera and light that help the doctor see the urinary passage and locate the stone.

The procedure does not require an external cut.

Step 3: Locating the Stone

Our urologist advances the instrument towards the stone and examines its position, size, and surrounding tissue.

The doctor may use imaging guidance when needed to understand the stone’s location and guide the instruments.

Step 4: Breaking the Stone With a Laser

If the stone is too large to remove directly, our urologist passes a laser fibre through the ureteroscope.

The laser breaks the stone into smaller pieces. The doctor may use a dusting technique to create tiny fragments or break the stone into pieces that can be removed.

Step 5: Removing the Stone Fragments

Our urologist may use a small basket to collect and remove suitable stone fragments.

Some tiny fragments may remain and pass naturally through urine after the procedure.

The doctor checks the treated area and removes accessible fragments according to the treatment plan.

Step 6: Placing a Ureteric Stent if Needed

After URS, our urologist may place a temporary tube called a double-J (DJ) stent inside the ureter.

The stent helps urine flow from the kidney to the bladder while swelling settles and the ureter recovers.

Our doctors may place a stent when they find swelling, ureteric irritation, injury, residual fragments, or another reason that makes temporary drainage necessary.

Not every patient needs a stent after an uncomplicated URS.

If our doctor places a stent, make sure you understand when and how the team will remove it. A temporary stent should not remain in place longer than our doctor recommends.

How Long Does the URS Procedure Take?

The duration of URS depends on the stone’s size, number, location, and complexity.

A straightforward ureteric stone may require less time than multiple stones or stones inside the kidney.

Your procedure may take longer when:

• The stone is large or difficult to reach.
• The patient has multiple stones.
• The doctor needs to break the stone into several fragments.
• The ureter has a narrow passage.
• The doctor needs to place a stent.
• The procedure involves additional treatment.

Our urologist can give you a more realistic estimate after reviewing your scans and medical history.

What Are the Benefits of URS for Kidney Stones?

URS offers several advantages for selected patients who need active stone removal.

1. No External Surgical Incision

Our urologist reaches the stone through the natural urinary passage. The procedure does not require an incision in the skin.

2. Direct Visualisation of the Stone

The ureteroscope has a camera that allows the doctor to see the stone directly. This helps our urologist locate and treat the stone.

3. Treats Stones in Different Parts of the Ureter

URS can treat stones in the upper, middle, and lower ureter. Flexible instruments can also reach selected kidney stones.

4. Laser Stone Fragmentation

Our urologist can use a laser to break a stone into smaller pieces. The doctor can then remove suitable fragments or allow tiny pieces to pass naturally.

5. Often Provides Stone Clearance in One Procedure

URS offers a good chance of clearing a ureteric stone in a single treatment session. However, some patients need another procedure if the stone burden is large or fragments remain.

6. No Shock Waves From Outside the Body

Unlike ESWL, URS does not use external shock waves. The doctor treats the stone directly using instruments passed through the urinary tract.

7. Suitable for Selected Patients With Certain Stone Characteristics

Our urologist may prefer URS when the stone’s location, density, or other clinical factors make this approach more suitable than alternative treatments.

The EAU guidelines note that URS can offer a better chance of achieving stone-free status with a single procedure compared with shock wave lithotripsy in appropriate patients. However, URS can also involve a higher complication rate and a longer hospital stay in some comparisons.

What Are the Risks and Complications of URS?

URS is a commonly performed procedure, but it still carries some risks. Our doctor explains these risks before surgery and takes precautions to reduce complications.

Possible risks include:

1. Blood in the Urine

• You may notice pink or slightly red urine after the procedure. The ureteroscope and stone treatment can irritate the urinary tract and cause minor bleeding.
• Heavy bleeding, blood clots, or bright red urine require medical assessment.

2. Urinary Tract Infection

• The procedure involves instruments entering the urinary tract. Some patients develop a urinary infection after surgery.
• Our doctor check a urine sample before the procedure and prescribe antibiotics when indicated.

3. Ureteric Injury

• The ureter has delicate tissue. The instrument or stone treatment can sometimes cause irritation, a small tear, or injury to the ureter.
• The doctor may place a stent to support drainage and healing if needed.

4. Ureteric Stricture

• Scar tissue can sometimes narrow the ureter after an injury or inflammation. This condition is called a ureteric stricture.
• A stricture may interfere with urine flow and require further evaluation or treatment.

5. Residual Stone Fragments

• The doctor may not remove every fragment during one procedure, particularly when the stone burden is large or the fragments are difficult to reach.
• Small remaining fragments may pass through urine, but some patients need follow-up imaging or another procedure.

6. Infection Spreading Into the Bloodstream

• In rare cases, a urinary infection can lead to sepsis, a serious medical emergency.
• Doctors reduce this risk by identifying and treating urinary infections before surgery and by using appropriate precautions during the procedure.

7. Anaesthesia-Related Complications

• General and spinal anaesthesia carry their own risks. The anaesthesiologist reviews your health, allergies, medicines, and medical history before choosing the safest approach.
• Your individual risk depends on your health and the complexity of the procedure.

What Is a DJ Stent After URS?

A double-J stent is a thin, flexible tube that our doctors place inside the ureter after selected URS procedures.

The stent has a curved end at the kidney and another curved end inside the bladder. These ends help keep it in position.

Why Does a Doctor Place a DJ Stent?

Our urologist may place a stent to:

• Maintain urine flow from the kidney to the bladder.
• Allow swelling in the ureter to settle.
• Support recovery after ureteric irritation or injury.
• Help urine drain when residual fragments remain.
• Reduce the risk of blockage in selected situations.

What Symptoms Can a DJ Stent Cause?

Some patients experience temporary discomfort while the stent remains in place.

Common symptoms include:

• Frequent urination
• Sudden urge to urinate
• Burning during urination
• Blood in the urine
• Discomfort in the lower abdomen
• Pain in the side or kidney area, especially during urination

These symptoms can vary from person to person. Our doctor prescribe medicines to manage stent-related discomfort.

How Long Does a DJ Stent Stay After URS?

The duration depends on why your doctor placed the stent and how your ureter responds after surgery.

Some stents remain for a few days, while others may stay for one or two weeks or longer when the clinical situation requires it.

Our urologist will give you a specific removal date or follow-up plan. Do not miss the appointment or try to remove the stent yourself.

How to Prepare for URS Surgery?

Proper preparation helps our doctor reduce risks and plan the procedure safely. Our doctor and anaesthesiologist recommend the following steps:

1. Complete the Required Tests

Our doctor recommend:

• Blood tests
• Urine routine examination
• Urine culture
• Ultrasound or CT scan
• Kidney function tests
• ECG or other pre-anaesthesia tests when appropriate

These investigations help the team understand your health and plan the procedure.

2. Inform Your Doctor About Your Medicines

Tell our urologist about all medicines and supplements you take.

Pay particular attention to blood thinners, diabetes medicines, blood pressure medicines, and medicines that may affect anaesthesia.

Do not stop any prescribed medicine on your own. Our doctor will tell you which medicines to continue or adjust.

3. Report Any Signs of Infection

Inform our doctor if you have fever, chills, burning urination, or other symptoms of a urinary infection.

The team may need to investigate and treat an infection before performing URS.

4. Follow Fasting Instructions

Our anaesthesiologist will tell you when to stop eating and drinking before surgery.

Follow these instructions carefully because they help reduce anaesthesia-related risks.

5. Arrange Transport After Surgery

Anaesthesia can temporarily affect alertness and coordination. Arrange for someone to accompany you home if our doctor plans to discharge you on the same day.

What Is the Recovery Time After URS?

Most patients recover gradually over the next few days. However, recovery depends on the stone’s size, procedure complexity, whether the doctor placed a stent, and the patient’s overall health.

Some patients return home on the same day, while others may need a longer hospital stay.

First 24 Hours After URS

You may experience:

• Mild burning while passing urine
• Pink or slightly bloody urine
• Frequent urge to urinate
• Mild discomfort in the lower abdomen
• Temporary discomfort in the side or kidney area

These symptoms often improve as your urinary tract recovers. Our doctor may prescribe pain-relief medicines and other medicines according to your needs.

Recovery During the First Few Days

You may gradually return to normal daily activities as your symptoms improve.

During this period:

• Drink fluids according to our doctor’s advice.
• Take prescribed medicines as directed.
• Avoid strenuous physical activity until your doctor permits it.
• Monitor your urine and body temperature.
• Attend your scheduled follow-up appointment.

If you have a DJ stent, you may continue to experience urinary urgency, discomfort, or mild blood in the urine until our doctor removes it.

Recovery After One to Two Weeks

Many patients resume their usual routine within this period, depending on the procedure and their recovery.

However, a fixed recovery timeline does not apply to everyone. Patients who undergo more complex procedures or experience complications may need additional time.

Our urologist will advise you when you can return to work, exercise, travel, and other activities.

What Should You Do After URS Surgery?

Following our doctor’s instructions can help you recover comfortably and reduce the risk of complications.

1. Drink Fluids as Advised

• Maintain adequate hydration unless your doctor has advised fluid restriction.
• Our doctor recommend increased fluid intake for a short period after the procedure, depending on your condition.

2. Take Medicines on Time

• Take pain-relief medicines, antibiotics, or other prescribed medicines exactly as directed.
• Do not start or stop medicines without discussing them with our doctor.

3. Avoid Heavy Exercise Initially

• Give your body time to recover. Avoid heavy lifting, strenuous exercise, and activities that increase discomfort until our doctor allows you to resume them.

4. Monitor Urine Colour and Urination

• Mild blood in the urine can occur after URS. However, heavy bleeding, blood clots, or difficulty passing urine need prompt medical attention.

5. Attend Your Follow-Up Appointment

• Our doctor may arrange imaging or urine tests to check the treatment outcome and confirm that the urinary tract drains properly.
• If you have a DJ stent, attend the appointment for its removal or exchange.

6. Follow Stone Prevention Advice

• If the laboratory analyses your stone, your doctor can use the results to recommend dietary changes or preventive treatment.
• Patients with recurrent stones may need additional tests to identify factors that increase stone formation.

What Are the Warning Signs After URS?

Contact our doctor promptly if you notice symptoms that suggest a complication.

Seek immediate medical attention if you experience:

• Fever or chills
• Severe or increasing pain
• Heavy bleeding or blood clots in the urine
• Inability to pass urine
• Repeated vomiting
• Severe weakness or feeling very unwell

Fever or chills after URS can indicate a urinary infection. Do not wait for the symptoms to settle on their own.

If you cannot pass urine or develop severe pain, seek urgent assessment.

What Is the Difference Between URS, RIRS, ESWL and PCNL?

Our doctors use different procedures to treat kidney and ureteric stones. The best option depends on the stone’s size, location, number, density, and the patient’s health.

Procedure	How it works	Common use
URS	A ureteroscope reaches the stone through the urinary passage; the doctor removes or breaks it	Ureteric stones
RIRS	A flexible ureteroscope reaches kidney stones and uses a laser to break them	Selected kidney stones
ESWL	External shock waves break the stone into smaller fragments	Selected kidney and ureteric stones
PCNL	The doctor reaches the kidney through a small opening in the back and removes the stone	Larger or complex kidney stones
Mini-PCNL	Uses a smaller access tract to remove selected kidney stones	Selected kidney stones

Which Procedure Is Better?

No procedure is best for every patient.

Our doctor may recommend URS for a ureteric stone that needs active removal. RIRS may suit selected stones inside the kidney, while PCNL often offers an appropriate option for larger or complex kidney stones.

ESWL may suit selected stones that doctors can break with external shock waves.

Our urologist reviews your scan and medical condition before explaining which treatment offers the most suitable approach.

How Can Jyoti Hospital Help With URS and Kidney Stone Treatment in Gurugram?

Kidney and ureteric stones can cause severe pain, urinary obstruction, infection, and other complications. Timely evaluation helps our doctor identify the stone and select the right treatment.

At Jyoti Hospital, Gurugram, our urology team evaluates patients with kidney and ureteric stones and recommends treatment according to their clinical condition.

Our urology services include:

• Evaluation and management of kidney and ureteric stones
• Endourology and laser stone surgery
• Ureteroscopy (URS)
• Retrograde Intrarenal Surgery (RIRS)
• Percutaneous Nephrolithotomy (PCNL)
• Mini-PCNL
• Extracorporeal Shock Wave Lithotripsy (ESWL)

Our doctors assess stone size, location, symptoms, and kidney function before recommending observation or a procedure. We also guide patients through preparation, follow-up, and stone prevention.

If your kidney stone causes persistent pain, urinary blockage, or repeated symptoms, consult our urology team to understand your treatment options.

Final Thoughts

URS is a minimally invasive procedure that helps doctors remove or break kidney and ureteric stones without making an incision in the skin. Our urologist passes a thin instrument through the urinary passage, locates the stone, and uses specialised instruments or a laser to treat it.

The procedure can offer effective stone removal for selected patients, particularly those with ureteric stones that do not pass naturally or cause persistent symptoms. However, URS also carries risks such as bleeding, infection, ureteric injury, and temporary discomfort from a DJ stent.

Recovery usually takes a few days to a couple of weeks, depending on the procedure and the patient’s condition. Follow our doctor’s instructions, attend follow-up appointments, and make sure you complete stent removal when our urologist recommends it.

If you have persistent kidney stone pain or a confirmed ureteric stone, consult our urologist at Jyoti Hospital, Gurugram, to understand whether URS or another treatment would suit your condition.

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FAQs

1. What is URS surgery for kidney stones?
   • URS, or ureteroscopy, is a minimally invasive procedure that allows our urologist to reach and treat stones inside the ureter and selected kidney stones. The doctor passes a thin instrument through the urinary passage and may use a laser to break the stone.
2. Is URS surgery painful?
   • Our doctors usually perform URS under general or spinal anaesthesia, so patients do not feel pain during the procedure. You may experience mild burning, discomfort, or blood in the urine after surgery. A DJ stent can also cause temporary urinary symptoms.
3. How long does a DJ stent stay after URS?
   • The stent may remain for a few days, one or two weeks, or longer when the clinical situation requires it. Our urologist will give you a specific removal or exchange plan. Always attend the scheduled appointment.
4. Can I pass urine normally after URS?
   • Most patients can pass urine after the procedure. However, temporary burning, frequent urination, urgency, or mild blood in the urine can occur. Contact our doctor if you cannot pass urine or develop severe symptoms.
5. Can kidney stones come back after URS?
   • Yes. URS removes or breaks existing stones, but it does not eliminate the factors that cause stone formation. Our doctor recommend stone analysis, dietary changes, fluid guidance, or metabolic tests to reduce recurrence.