URSL Surgery - Purpose, Procedure, Benefits, Side Effects

Medically Reviewed by
Dr. Prince Gupta
Ureteroscopy (URSL)

Treatment Duration

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30 Minutes

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90 Minutes

Treatment Cost

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50,000

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1,40,000

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Ureteroscopy (URSL)
Medically Reviewed by Dr. Prince Gupta Written by Sangeeta Sharma

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According to a study by Singh et al., 2023, the prevalence of kidney stones in India is about 12%, which makes them a significant health concern. Ureteroscopy with lithotripsy, URSL full form, is a common and effective procedure used to address this issue. It involves using a ureteroscope to locate and break down kidney stones without requiring invasive surgery.

URSL allows for the direct visualisation and treatment of stones within the ureter and kidney. Due to its high success rate and minimal postoperative discomfort, it has become a preferred method for patients and doctors. Continue reading to know more about the benefits, risks, and recovery of the procedure. 

Procedure Name 

Ureteroscopy with Lithotripsy 

Alternative Name 

Ureteroscopic lithotripsy 

Conditions Treated 

Kidney stones 

Benefits of the Procedure 

No incisions, shorter hospital stay, faster recovery 

Treated By 

Urologists 

You can check Ureteroscopy (URSL) Cost here.

What is URSL?

URSLfull form is ureteroscopy with lithotripsy. It is a minimally invasive surgery used to remove kidney stones lodged in the ureter (carry urine from the kidneys to the bladder). It involves two procedures: 

  1. Ureteroscopy: A ureteroscope (small, flexible telescope) is used to locate the stone inside the ureter. 

  2. Lithotripsy: A laser or shock wave is used to break the stone into tiny pieces. 

Anatomy and Physiology of the Kidney

The kidneys are two bean-shaped organs on both sides of the spine. They are situated below the rib cage and are approximately the size of a fist. 

Each kidney consists of an outer cortex and an inner medulla. These sections contain nephrons, the functional units of the kidneys. The organs receive blood from the renal artery, and the filtered blood leaves through the renal vein.

The functions of the kidney are as follows: 

  1. Excretion of waste products in the urine 

  2. Reabsorption of essential nutrients from blood 

  3. Maintaining the pH balance of the body 

  4. Achieving the fluid and electrolyte balance 

  5. Regulating blood pressure

Who Needs URSL?

URSL is typically recommended for stones too large to pass through the urinary tract naturally. It may be performed for individuals who experience the following symptoms due to kidney stones

  1. Recurrent urine tract infections

  2. Blockage of urine flow 

  3. Severe pain during urination 

  4. Decreased frequency of urination 

  5. Pain in the abdomen 

URSL Procedure

The URSL surgery is performed under general anaesthesia. Completed within 30 to 90 minutes, it involves the following steps: 

  1. A ureteroscope is inserted through the urethra and passed through the bladder to reach the ureter or kidney.

  2. After the stone is located, it is treated with a laser to break it into smaller, manageable pieces.

  3. Fragments of the stone are either retrieved using a basket-like device inserted through the ureteroscope or left to pass naturally in the urine. 

  4. Sometimes, a DJ stent (a ureteral stent used to treat urinary tract disorders) may be placed temporarily within the ureter to facilitate the passage of stone fragments.

  5. Once all stones have been treated or removed, the ureteroscope is withdrawn. 

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Before and on the Day of URSL

Patients consult with a urologist to prepare for their URSL procedure. The specialist offers detailed instructions that must be followed both before and on the day of the surgery. 

Before URSL 

During the initial doctor consultation, patients ask questions and address concerns regarding the procedure. The medical expert explains the steps involved in the surgery. Preparations before URSL include: 

Parameters 

Pre-requisites 

Pre-op Assessment 

  1. Complete blood count 

  2. Urinalysis 

  3. CT scan or X-ray 

Risk Evaluation 

  1. Allergies 

  2. Risks vs benefits 

Restrictions 

Blood thinners and pain relievers 7-10 days before surgery 

Anaesthesia Selection 

General 

Fasting 

8-12 hours before the procedure 


On the Day of URSL 

Individuals should arrange for someone to drive them home after the procedure. Once they reach the hospital, the following preparations take place: 

Parameters 

Pre-requisites 

Consent 

Mandatory 

Surgical Preparation 

Changing into a hospital gown 

Physical Evaluation 

Vitals check-up (blood pressure, heart rate, temperature, etc.)

IV Line

Yes, for fluids and medications 

Patient Positioning

Lying on the back with legs in stirrups 

After URSL and Recovery

It is normal to experience pain while urinating and a small amount of blood in the urine for the next 24 hours after the procedure. Patients should follow their doctor’s instructions in the hospital and at home to ensure a quick and smooth recovery. 

In Hospital Recovery 

After ureteroscopic lithotripsy, patients can return home on the same day once the effect of anaesthesia wears off. This could take one to four hours. During this hospital stay, one can expect the following: 

  1. Individuals are taken to a recovery room where the nursing staff checks their vitals, including breathing and blood pressure. 

  2. Discomfort is often managed with prescribed pain relievers. 

  3. Drinking water for the next two hours is important to help flush out any remaining stone fragments. 

At-home Recovery 

Patients can expect to feel better within 5-7 days after the URSL procedure. Once they reach home, they should follow these guidelines: 

  1. Rest for 24 hours.  

  2. Take prescribed antibiotics for 4-5 days to prevent infection and pain relievers to manage discomfort. 

  3. Drink four to six glasses of water daily to remove stone remnants from the urinary tract. 

  4. Avoid strenuous activities for one week to prevent bleeding. 

Follow-up Appointment

The first follow-up appointment is scheduled for 7-10 after the surgery. During this visit, the doctor performs imaging tests like ultrasound or X-ray to ensure all stone fragments have been removed or passed. These also confirm that no new stones have formed and that the urinary tract is healing well.

If a ureteral stent was placed during the procedure, it will be removed at this visit. 

Benefits of URSL

URSL is a highly efficient approach to managing kidney and ureter stones. According to a study by Bhatia et al., 2019, the success rate of the procedure in single lower ureteric stones is about 75%. The benefits of the surgery over traditional operations are as follows: 

  1. No incisions or stitches 

  2. Reduced pain and bleeding after surgery 

  3. Shorter hospital stays 

  4. Faster recovery 

  5. Low rate of complications like infections 

Risks and Complications After URSL

URSL is considered a relatively safe procedure. According to Murtadha et al., 2019, the risk of major complications after the procedure is 0.8% to 1.5%. The risks may include the following: 

  1. Urinary tract infection 

  2. Bleeding 

  3. Ureteral injury 

  4. Narrowing or scarring of the ureter 

  5. Adverse reaction to anaesthesia 

  6. Difficulty breathing 

When to call a doctor?

After undergoing URSL, patients should monitor their recovery and be alert for signs of complications. It is important to contact the doctor immediately if they experience any of the following:

  1. Intense pain that does not improve with medications 

  2. A fever above 101 F 

  3. Severe burning sensation while urinating 

  4. Difficulty urinating 

  5. Excessive haematuria (blood in the urine)

Risks of Delaying URSL

Delaying URSL can lead to several significant complications, particularly for individuals with problematic kidney or ureteral stones. Here are some common risks:

  1. Stones left untreated can grow larger over time, making them more difficult to remove with less invasive procedures.

  2. They can obstruct urine flow, leading to severe pain and increasing the risk of recurrent urinary tract infections. 

  3. Untreated stones may cause significant pain, haematuria, or discomfort during urination, reducing the patient’s quality of life.

  4. Long-term urinary obstruction due to stones can impair kidney function or cause permanent kidney damage.

Cost of URSL 

The ureteroscopy cost in India is subject to variation based on several factors. It generally starts at ₹ 50,000 and reaches ₹ 1,40,000. The average price of the surgery is ₹ 90,000. 

Procedure Name 

Estimated Cost Range 

Ureteroscopy (URSL)

₹ 50,000 to ₹ 1,40,000

Note: This cost is approximate. Patients are advised to consult HexaHealth experts for the most current and accurate procedure expenses. 

Factors that affect the price of surgery include: 

  1. Type of Facility: Procedures performed in private hospitals cost more than those in government centres due to advanced facilities and specialised services. 

  2. Geographical Location: Metropolitan cities and urban areas are costlier than smaller towns and rural regions due to cost of living and healthcare infrastructure differences. 

  3. Surgeon’s Fees: Urologists with more experience or a strong reputation may charge higher fees. This can impact the overall expenditure of the procedure.

  4. Stent Removal and Placement: A URSL with DJ stenting facilitates stone passage, which can add to the total cost. 

  5. Insurance: The extent of insurance coverage helps determine out-of-pocket costs.

Takeaway

URSL full form is Ureteroscopic lithotripsy. It is a minimally invasive surgery that offers an effective solution for removing kidney and ureteral stones. It allows for the direct visualisation and fragmentation of stones. Due to its quick recovery period, doctors may recommend URSL for eligible patients. 

If you have been advised URSL, HexaHealth can be your best choice! Our network of experienced urologists ensures the procedure is performed with precision and care. We guide you through every step of the surgery, from diagnosis to postoperative care. Patients receive the highest quality of treatment for successful outcomes.

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Frequently Asked Questions (FAQ)

Ureteroscopy with lithotripsy, URSL full form, is a minimally invasive procedure. A thin, flexible ureteroscope is used to locate and break down stones in the urinary tract. It allows for the removal of kidney and ureteral stones through the urethra.

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URSL is performed under general anaesthesia to make the patient unconscious. It involves the following steps: 

  1. A ureteroscope is inserted through the urethra, up into the bladder and ureter. 

  2. Once the stone is located, it is fragmented with a laser or lithotripsy device. 

  3. The pieces are either extracted or left to pass naturally.

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Ureteroscopy with laser lithotripsy is used for stones up to 2 centimetres in size. It is especially useful for stones in the ureter or kidney that are challenging to treat through other non-invasive methods.

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The ureteroscopy cost varies widely, typically ranging from ₹ 50,000 to ₹ 1,40,000, depending on factors like the healthcare facility and geographic location. However, this price is an estimate. Patients should consult HexaHealth experts for accurate expenses. 

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Yes, the URSL procedure is performed under general anaesthesia. This ensures that the patient is unconscious and comfortable during surgery. 

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URSL offers a high success rate in treating kidney stones. The procedure offers various benefits, including: 

  1. No external incisions

  2. Reduced complications 

  3. Quicker recovery time 

  4. Shorter hospital stays

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During recovery after URSL surgery, patients can expect mild pain and blood in the urine for 24 hours. It is important to follow these guidelines: 

  1. Take prescribed pain relievers and antibiotics. 

  2. Drink lots of water to pass the stone fragments. 

  3. Refrain from strenuous activities for about one week.

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URSL is highly effective for treating kidney stones. According to a study by Featherstone et al., 2017, it has a stone-free rate of 91% for large adult stones. 

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Ureteroscopic lithotripsy usually takes 30 to 90 minutes. The exact duration is based on the size, number of stones being treated, and the complexity of accessing their location within the urinary tract.

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Ureteroscopy with lithotripsy is generally safe. However, like any surgery, complications can occur, which include: 

  1. Bleeding 

  2. Infection 

  3. Ureteral injury 

  4. Scarring of the ureter

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Ureteroscopy can effectively remove kidney stones up to 2 centimetres, particularly those in the ureter or kidney. However, extremely larger stones greater than 2 centimetres may require a more invasive procedure like percutaneous nephrolithotomy.

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The success rate of ureteroscopy is high and depends on factors like stone size and location. According to Bhatia et al., 2019, its success rate in single lower ureteric stones is about 75%.

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The best surgery for kidney stone removal depends on the size and location of the stone. Options include the following: 

  1. Shock wave lithotripsy: Stones up to 2 cm in size that are not located in the lower kidney.

  2. Ureteroscopy with lithotripsy: Stones up to 2 cm in size located anywhere in the kidney or ureter.

  3. Percutaneous nephrolithotomy: Stones larger than 2 cm.

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References

All the articles on HexaHealth are supported by verified medically-recognized sources such as; peer-reviewed academic research papers, research institutions, and medical journals. Our medical reviewers also check references of the articles to prioritize accuracy and relevance. Refer to our detailed editorial policy for more information.


  1. Singh S, Gupta S, Mishra T, Banerjee BD, Sharma T. Risk Factors of Incident Kidney Stones in Indian Adults: A Hospital-Based Cross-Sectional Study. Cureus. 2023 Feb 27;link
  2. Newman T. Kidneys: Structure, function, and diseases [Internet]. www.medicalnewstoday.com. 2023. link
  3. Ureteroscopy with Laser Lithotripsy: Treatment for Kidney Stones [Internet]. Healthline. 2022.link
  4. Ureteroscopy and Laser Lithotripsy» Department of Urology» College of Medicine» University of Florida [Internet].link
  5. Ureteroscopy for Kidney Stone Diagnosis [Internet]. WebMD.link
  6. Ureteroscopy: MedlinePlus Medical Encyclopedia [Internet]. medlineplus.gov.link
  7. Ureteroscopy (URS) [Internet]. Patient Information. [cited 2024 May 9]. link
  8. Bhatia R, Hameed T, Lal P, Bains L, Sawant G, Maranna H. Evaluation of Outcome of Ureteroscopic Pneumatic Lithotripsy in Single Lower Ureteric Calculus and Its Association with CT Parameters. Open Journal of Urology [Internet]. 2019 Oct 16 [cited 2024 May 9];9(10):153–61.link
  9. Almusafer M, Jawad Al-Tawri A. Complications of ureteroscopic stone lithotripsy: A multicentre local study. Hamdan Medical Journal. 2019;12(3):119.link
  10. Better Health Channel. Kidney stones [Internet]. Vic.gov.au. 2012.link
  11. Definition & Facts for Kidney Stones | NIDDK [Internet]. National Institute of Diabetes and Digestive and Kidney Diseases.link
  12. Kidney Stones | Michigan Medicine [Internet]. www.uofmhealth.org.link
  13. Featherstone NC, Somani BK, Griffin SJ. Ureteroscopy and laser stone fragmentation (URSL) for large (≥1 cm) paediatric stones: Outcomes from a university teaching hospital. Journal of Pediatric Urology. 2016 Aug;link
Disclaimer: The information provided here is for educational and learning purposes only. It doesn't cover every medical condition and might not be relevant to your personal situation. This information isn't medical advice, isn't meant for diagnosing any condition, and shouldn't replace talking to a certified medical or healthcare professional.

Reviewer

Dr. Prince Gupta

Dr. Prince Gupta

MBBS, MS Orthopaedics, Fellowship in Arthroplasty, MCh Orthopaedics, Fellowship in Joint Replacement

18 Years Experience

Dr Prince Gupta is a well-known orthopaedic surgeon currently associated with Manipal Hospital, Gurugram. He has 18 years of experience in orthopaedics and worked as an expert in different cities of India. He has worked in many reputed h...View More

Author

Sangeeta Sharma

Sangeeta Sharma

BSc. Biochemistry I MSc. Biochemistry (Oxford College Bangalore)

6 Years Experience

She has extensive experience in content and regulatory writing with reputed organisations like Sun Pharmaceuticals and Innodata. Skilled in SEO and passionate about creating informative and engaging medical conten...View More

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