Ureteroscopic Lithotripsy (URSL) Procedure & Recovery : Dr. Yasir Iqbal

URSL (Ureteroscopic Lithotripsy) is a minimally invasive surgical procedure used to treat stones located in the ureter—the tube that carries urine from the kidney to the bladder. It is one of the most effective and commonly performed treatments for ureteric stones that are too large to pass on their own or are causing pain, infection, or obstruction.

When is URSL Recommended?

Ureteroscopic Lithotripsy (URSL) is a minimally invasive procedure used to treat stones in the urinary tract. The decision to proceed with URSL depends on several factors, such as the stone’s size, location, type, and the patient’s symptoms. Below are common situations where URSL may be the preferred treatment:

🔹 Stones of Small to Moderate Size

URSL is most effective for stones that are small to medium in size, generally measuring up to 1 cm.

• Stones larger than this may be more difficult to treat with URSL alone and might need other procedures like PCNL or laser-based techniques.

🔹 Stones Located in the Ureter

This procedure is especially useful for ureteric stones—those that are stuck in the tube connecting the kidney to the bladder.

• URSL allows the surgeon to see the stone clearly and either remove it or break it into smaller pieces.

🔹 Stones in the Renal Pelvis

URSL can also be used for stones found in the renal pelvis, the central area of the kidney that collects urine.

• Flexible ureteroscopes allow access to this region for precise treatment.

🔹 Failure of Conservative Treatment

When methods such as increased fluid intake, medications, or watchful waiting fail to clear the stone, URSL becomes an effective next step.

• It's also considered when non-invasive techniques like shockwave lithotripsy do not work.

🔹 Stones of Various Compositions

URSL works for different types of stones, including:

• Calcium-based stones (oxalate or phosphate)

• Uric acid stones

• Mixed composition stones

The technology used in URSL can fragment and remove most stone types.

🔹 Obstruction, Pain, or Complications

When a stone causes urinary blockage, leads to kidney swelling (hydronephrosis), triggers severe pain, or begins to affect kidney function, URSL is often the fastest and most direct treatment.

• It is also used when stones cause recurrent infections or other complications.

Preparing for URSL (Ureteroscopic Lithotripsy)

If you're scheduled for URSL, proper preparation is essential to ensure the procedure goes smoothly and reduces the risk of complications. Your urologist will provide personalized instructions, but here are some general steps most patients are advised to follow:

🩺 1. Inform Your Doctor About Medications

• Share a complete list of prescription medicines, over-the-counter drugs, and supplements you take regularly.

• Some medications, particularly blood thinners, may need to be paused a few days before the surgery to lower the risk of bleeding.

• Do not stop or adjust any medication unless directed by your doctor.

🩺 2. Discuss Medical History and Allergies

• Make sure to discuss your medical background, ongoing health issues, and any previous reactions to medications or anesthesia.

• This helps your medical team take necessary precautions during and after the procedure.

🕐 3. Fasting Guidelines

• You’ll likely be advised to avoid eating or drinking for 6 to 8 hours before the surgery.

• This precaution helps prevent issues with anesthesia and ensures a safer surgical experience.

🚭 4. Avoid Tobacco Products

• Stop smoking or using tobacco products in the days leading up to and after the procedure.

• Smoking can slow down healing and may increase the chances of complications.

🏡 5. Arrange for Post-Surgery Care

• Since the procedure involves anesthesia, arrange for someone to drive you home afterward.

• You might also want to plan for a short rest period at home before returning to your normal routine.