Flexible Ureteroscopy & Laser Lithotripsy

What is this procedure?

Flexible ureteroscopy with laser lithotripsy is a minimally invasive, keyhole procedure to treat kidney or ureteric stones. A slim, flexible telescope (ureteroscope) is passed through the urethra and bladder, then up the ureter to reach the stone. A holmium laser fibre is then used to break the stone into tiny fragments or fine dust, which either pass naturally with urine or are removed with a small basket. No incisions are made in the skin. The procedure is usually performed as a day case under general or spinal anaesthesia.

Before your procedure

• Fasting: Do not eat or drink anything for at least six hours before your admission time.
• Urine infection: A urine culture is routinely taken in advance. If an infection is present it must be treated with antibiotics before proceeding. Inform the team if you have had urinary symptoms.
• Medications: Continue most regular medications. Blood thinners must be adjusted according to Dr Hadjipavlou’s specific instructions — do not stop them independently.
• Imaging: Bring any recent CT scan results or imaging discs to your pre-operative appointment.
• What to bring: Comfortable, loose clothing; photo ID and insurance documents.

What happens during the procedure

After anaesthesia, the flexible ureteroscope is guided up through the natural urinary passages. A small plastic tube called a ureteric access sheath may be placed to ease access and protect the ureter. The laser fibre fragments the stone under direct vision. The procedure typically takes 30–90 minutes depending on stone size and location. A ureteric stent — a soft plastic tube from the kidney to the bladder — is frequently left in place at the end of the operation to protect the ureter while swelling settles and any remaining fragments pass.

After the procedure and recovery

• Stent: If a stent has been placed, it is usually removed at a separate outpatient appointment using a flexible cystoscope, typically 1–2 weeks later. Some stents have an external string for self-removal — you will be given clear instructions.
• Haematuria: Pink or blood-stained urine is expected for a few days. Drink at least 2 litres of fluid daily.
• Stent symptoms: While a stent is in place you may notice urinary frequency, urgency, mild discomfort in the loin or bladder area, and occasional blood in the urine. These are normal; prescribed medication can help.
• Driving: Avoid driving for 24 hours after general anaesthesia and until comfortable. If a stent is in situ, check with Dr Hadjipavlou before driving long distances.
• Return to work: Most patients can return to a desk job within a few days; avoid heavy lifting for 1–2 weeks.
• Activity: Gentle walking is encouraged from day one. Avoid strenuous exercise until the stent (if placed) is removed.

When to seek medical help

Contact the secretary on 22 444 444 or El Greco Medical Centre +357 22 782 000 out of hours if you experience:

• Fever above 38 °C, shivering or rigors
• Severe loin or abdominal pain not controlled by pain relief
• Inability to pass urine
• Heavy or persistent bright-red bleeding

Attend the nearest Accident & Emergency department immediately if you feel acutely unwell or cannot reach us.