Once you are asleep, the surgeon passes a small lighted tube (ureteroscope), through the urethra and bladder and into the ureter to the point where the stone is located. If the stone is small, it may be snared with a basket device and removed whole from the ureter. If the stone is large and/or if the diameter of the ureter is narrow, the stone will need to be fragmented, which is usually accomplished with a laser. Once the stone is broken into tiny pieces, these pieces are usually removed from the ureter. In most cases, to ensure that the kidney drains urine well after surgery, a ureteral stent is left in place.

Ureteroscopy can also be performed for stones located within the kidney. Similar to ureteral stones, kidney stones can be fragmented and removed with baskets. Occasionally, a kidney stone will fragment with a laser into very small pieces (grains of sand), too small to be basketed. The urologist will usually leave a stent and allow these pieces to clear by themselves over time. Lastly, if the ureter is too small to advance the ureteroscope, the urologist will usually leave a stent, allowing the ureter to “dilate” around the stent, and reschedule the procedure for 2-3 weeks later. Ureteroscopy is usually performed as an outpatient procedure. Some patients, however, may require an overnight hospital stay if the procedure proves lengthy or difficult.