URSL (ureteroscopy): a controlled, minimally invasive way to remove a ureteric stone
If you've been told you need 'URSL,' it usually means the stone is in the ureter (the tube connecting kidney to bladder) and is not passing safely or comfortably. This is often after: repeated pain episodes, persistent obstruction on imaging, lack of progress over time, job/travel constraints where waiting is not reasonable, or infection risk (in which case timing becomes urgent). URSL is a standard, widely performed procedure. The most important thing is ensuring: the stone truly requires intervention, the infection/obstruction risks are handled properly, and you understand what to expect, including stent-related symptoms.
Quick navigation
When URSL is recommended (and when waiting is safe)
URSL is commonly recommended when:
The stone is unlikely to pass based on size/location. Pain keeps recurring or cannot be managed safely at home. Obstruction is persistent, with hydronephrosis on imaging. There is infection risk (fever/chills). You have one kidney, kidney disease, pregnancy, or other contexts where waiting carries higher risk. You've had no meaningful progress over a reasonable watchful period.
When waiting can be reasonable
If: there is no fever/infection, pain is controlled, kidney function is safe, and the stone characteristics suggest a reasonable chance of passage—then conservative management may be appropriate, with follow-up imaging.
Before URSL: what tests matter
1) Urine test (routine + culture in selected cases)
Rules out infection, helps decide antibiotic strategy.
2) Imaging
URSL planning depends on knowing: exact stone location, size, degree of obstruction. Most often: ultrasound is initial, CT KUB is the most precise for planning.
3) Kidney function (selected cases)
Important when obstruction has been prolonged or if patient has kidney disease.
What happens during URSL
URSL is performed through the natural urine passage. In simple terms: A thin endoscope is passed via the urethra into the bladder and then into the ureter. The stone is visualized. A laser is used to fragment the stone. Fragments may be removed or allowed to pass depending on the situation. Often, a stent is placed to ensure drainage and reduce obstruction risk from swelling. No skin incision is typically needed for standard URSL.
Laser and stone fragments: what is actually done?
Patients often imagine the stone is 'pulled out whole.' Sometimes it can be, but often the stone is: fragmented into smaller pieces (laser lithotripsy), fragments are extracted with baskets or left as fine dust to pass naturally. The aim is safe clearance with minimal trauma. If stone fragments are retrieved, analysis can help with prevention planning later.
Stent: why it is placed and what it feels like
Why a stent is placed
The ureter can swell after instrumentation. Swelling can obstruct urine temporarily. The stent maintains drainage from kidney to bladder. It reduces risk of painful blockage after the procedure. It can protect kidney function when obstruction risk is high.
What a stent can feel like (common, manageable)
Many patients experience: frequency/urgency, burning sensation, discomfort in lower abdomen or flank (especially at the end of urination), mild blood in urine. These symptoms are common and usually temporary. The key is being told in advance so you do not worry unnecessarily. Stent duration depends on stone complexity, swelling, and surgeon judgment.
Recovery timeline (realistic)
First 24–72 hours
Urinary burning and frequency are common. Mild hematuria can occur. Discomfort fluctuates, especially with a stent. Pain medicines and hydration guidance are used.
First 1–2 weeks
Most people return to routine activities within days (job-dependent). Symptoms usually improve as irritation settles. Stent removal timing is planned (when used).
After stent removal
Many patients feel noticeably better within 24–48 hours. Some mild burning can persist briefly.
Risks and side effects
URSL is common, but it is still a procedure. Potential risks include: infection (risk minimized with proper screening and antibiotics), bleeding (usually mild), ureteric injury (rare with experienced hands, but possible), residual fragments requiring follow-up, stent discomfort. Seek urgent evaluation if: fever/chills, severe flank pain with fever, inability to pass urine, severe uncontrolled pain, heavy bleeding with clots.
URSL vs RIRS vs mini-PCNL (how they differ)
URSL
Typically for stones in the ureter. Scope goes to ureter, laser fragments stone.
RIRS
Typically for stones in the kidney (selected patterns). Flexible scope reaches kidney and fragments stone.
Mini-PCNL
For larger or complex kidney stones. Direct small tract access to kidney.
FAQs
Talk to a doctor / plan your URSL
If you're considering URSL, the most useful inputs are: CT KUB or ultrasound report, urine report (and culture if done), whether there is fever/chills, kidney function report if you have one kidney or known kidney disease. We will guide you on: whether URSL is truly the right approach, whether urgent drainage is needed first (if infection risk exists), stent expectations and recovery planning, and prevention planning after the episode.
