Severe ureteric colic with fever? An infected obstructed ureter is a urological emergency — requires immediate JJ stenting or drainage before URS. Call now.
Ureteroscopy (URS) with Holmium laser is the most effective day-care procedure for ureteric and kidney stones, and URS surgery in Ahmedabad offers high stone-free rates with same-day discharge. A thin scope passed through the urethra — no incision, no puncture — fragments the stone directly. Home the same day, back to work in 2–3 days, 95% stone-free for ureteric stones.
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Ureteroscopy (URS) is an endoscopic procedure in which a thin telescope — the ureteroscope — is passed through the urethra and bladder and up into the ureter or kidney to treat stones directly. Under general or spinal anaesthesia, a Holmium laser is applied to the stone — fragmenting it into tiny pieces that pass naturally or are retrieved with a small basket. No skin incision, no puncture, no external shock waves. The ureteroscope goes to where the stone is, through the body’s natural passages.
URS surgery is the most versatile stone treatment available. Semi-rigid URS treats ureteric stones at any level with a 95% stone-free rate in a single day-care procedure. Flexible URS — with its steerable deflectable tip — accesses all calyceal groups inside the kidney, including the lower pole where semi-rigid scopes and ESWL cannot reach effectively. For kidney stones under 2cm, Flexible URS kidney stone surgery achieves 85–90% stone-free rate. The JJ stent placed at the end of the procedure is removed at 2–4 weeks as a brief outpatient procedure — completing the treatment.
URS surgery treatment selection depends on stone location (ureter vs kidney), stone size, prior treatment history and whether there is associated obstruction or infection. These are the situations where URS is the first-choice or preferred treatment.
URS treats both acute stone episodes causing severe pain and elective stone disease found on scanning. Know which symptoms need emergency assessment and which allow time for planned treatment.
Stone + fever = infected obstructed ureter (pyonephrosis) — a urological emergency. Requires immediate JJ stenting or nephrostomy drainage BEFORE URS. URS must not be performed on an infected system — sepsis risk is life-threatening. Call immediately.
Severe loin-to-groin pain in waves, unable to find a comfortable position, nausea and vomiting preventing oral analgesia — renal colic from a ureteric stone. When pain cannot be controlled with oral or IM analgesia, emergency assessment for IV analgesia and imaging is needed. URS planned within 48 hours in cases of ongoing uncontrolled colic.
Ureteric stone managed conservatively with tamsulosin (medical expulsive therapy) — not passed after 4 weeks. At this point, continued conservative management risks silent kidney damage from sustained obstruction. URS is planned to remove the stone definitively before renal function is affected.
JJ stent placed as emergency drainage — definitive stone treatment (URS) planned. The stent is bridging treatment only — the stone must still be removed by URS at the elective procedure. Do not allow stent to remain beyond 3–4 months without stone treatment being arranged.
Asymptomatic or mildly symptomatic kidney stone under 2cm found on ultrasound or CT. Flexible URS clears the stone electively before it causes acute colic, obstruction or infection. Lower pole stones and hard stones are particularly well suited to flexible URS rather than ESWL.
Visible or microscopic blood in urine with a confirmed stone on imaging. The stone is scraping the urothelium. Haematuria always warrants urine cytology and imaging to confirm stone as the cause — and a treatment plan for the stone itself.
Patient with second or subsequent stone episode — URS for the acute stone combined with stone composition analysis and metabolic evaluation. Recurrent stone formers have the most to gain from metabolic investigation — an identified cause can be specifically treated, reducing recurrence from 50% to under 15%.
Urinary frequency, urgency, mild loin ache and pink urine — classic JJ stent symptoms after prior emergency stenting or URS. All expected and normal. Stent should be removed at 2–4 weeks by outpatient flexible cystoscopy — symptoms resolve immediately on removal.
Semi-rigid URS for ureteric stones, flexible URS for kidney stones — with Holmium laser for all stone types. The right technique and energy source are selected based on stone location, size and composition.
URS kidney stone surgery in Ahmedabad depends on experience with flexible scopes, laser technique, stent management and the completeness of metabolic follow-up.
Senior Consultant Urologist — Endourology & Ureteroscopy Specialist, Trayam Hospital
Dr. Renish Patel has performed over 3,000 ureteroscopy procedures — including complex flexible URS for kidney stones, difficult impacted ureteric stones, single-kidney cases and stone treatment in pregnancy. The approach is precise: map the stone with CT before every procedure, confirm sterile urine, choose the right scope and laser technique, and always complete metabolic evaluation so the stone that is removed is the last one the patient needs to have treated.
Ureteric and kidney stones are frequently treated with ESWL when URS would achieve a better result in a single session. The decision between ESWL and URS should be based on stone location, size and density on CT — not on which treatment is more convenient or requires less anaesthesia. Many patients endure two or three ESWL sessions before URS is finally offered — having accumulated radiation, delay and cost for an inferior outcome.
Stone density (Hounsfield units) and lower pole anatomy on CT determine whether ESWL or URS gives the better outcome. We review the CT before recommending any treatment. High-density or lower pole stones are directed to URS — not ESWL — from the start.
Urine culture checked within 2 weeks of every URS. Any infection treated and repeat culture confirmed sterile before proceeding. This is the single most important preventable safety step in stone surgery — and we never skip it.
Second stone? We arrange stone composition analysis and 24-hour urine metabolic evaluation after URS — every time. An identified cause prevents the third stone. Without this, recurrence continues unchecked at 50% per decade.
Ureteric stone causing colic? Kidney stone found on scan? ESWL not working? — Bring your CT or ultrasound report if you have one. We’ll tell you whether URS or another approach gives the best result for your specific stone — and arrange it efficiently.
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URS recovery is one of the fastest in all of urology — most patients go home the same day. The prevention work that follows is what determines whether this is the last stone you ever need treated.
URS passes a scope through the urethra to the stone — Holmium laser fragments it directly. Day care, no incision, 95% stone-free for ureteric stones. ESWL uses external shockwaves — no anaesthesia but lower stone-free rates. PCNL is a back puncture for stones over 2cm. URS is the most versatile — effective for all ureteric stones and kidney stones under 2cm.
Flexible URS has a steerable deflectable tip — accessing all calyceal groups inside the kidney including lower pole where semi-rigid scopes cannot reach. Used for kidney stones under 2cm, upper ureteric stones and lower pole stones. Stone-free rate 85–90% for kidney stones under 2cm.
Yes — most commonly general anaesthesia, spinal in selected cases. Takes 30–60 minutes. Recovery room 2–3 hours then day-care discharge. Same-day home in the majority of cases.
A soft tube inside the ureter from kidney to bladder — keeps the ureter open while post-procedure swelling settles. Causes urinary frequency, mild loin ache and pink urine — all normal. Removed at 2–4 weeks as a brief outpatient cystoscopy under local anaesthetic — symptoms resolve immediately.
Ureteric stones of any size — 95% stone-free. Kidney stones under 2cm with flexible URS — 85–90% stone-free. For kidney stones over 2cm, PCNL is generally more effective.
Yes — URS is the preferred treatment for ureteric stones in pregnancy requiring intervention. No radiation needed. ESWL is absolutely contraindicated in pregnancy. Fluoroscopy-free technique available.
Very safe procedure. Minor: UTI (1–3%), stent symptoms (expected and temporary), pink urine for 1–2 days. Major complications rare: ureteric perforation under 1%, sepsis if performed with infected urine (preventable). Sterile pre-operative urine is the most important safety measure.
Day-care procedure — home same day. With stent: urinary frequency and mild loin ache for 2–4 weeks. Desk work at 2–3 days. Heavy work after stent removal at 2–4 weeks. Stent removal takes 5 minutes outpatient — symptoms gone within hours.
Without prevention — 50% recurrence at 10 years. Stone composition analysis and metabolic evaluation after URS, with a personalised prevention plan, reduces this to under 15%. Offered to every URS patient at Trayam.
Yes — URS surgery in Ahmedabad is covered under PMJAY and all major Indian health insurance policies. Trayam is empanelled with leading insurers, and our team manages cashless pre-authorisation and complete claim support.
Bring your CT or ultrasound report if you have one — or we start with a CT KUB. We'll map your stone, give you rapid pain relief and plan the right procedure to clear it first time.
