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Ureteropyeloscopy and Laser Lithotripsy

General / Indications - When stones get caught in the ureter during passage to the bladder, and urinary obstruction due to impaction of the stone occurs. This is often seen with stones larger than 5mm in size. If these stone fragments do not pass spontaneously after conservative therapy (i.e. hydration and pain medication), then ureteropyeloscopy and laser lithotripsy may be required. (ESWL can also often be used to treat these stones - depending on their location).

Procedure - Ureteropyeloscopy is usually done under general anesthesia. Ureteropyeloscopy is performed by introducing a small telescope (called a ureteroscope) through the urethra, into the bladder, and up the ureter. With direct visualization of the stone within the ureter, a laser fiber can be used to fragment the stone into smaller pieces. A ureteral stent is often required with this procedure. Ureteropyeloscopy with laser lithotripsy can require anywhere between 1-3 hours depending on the size and location of the stone within the urinary tract.

Percutaneous Nephrostolithotomy (PCNL)

General / Indications - For kidney stones larger than 2 centimeters in size or for hard stones, a more invasive but extremely effective therapy called percutaneous nephrostolithotomy is generally recommended.