Trans Ureteral Lithotripsy (TUL)

Ureteroscopy is a common procedure whereby a stone can be removed via a special telescope, or in certain instances, a laser can be used to break the stone up into very small bits that can be passed.  Ureteroscopy is done under anesthesia in the operating room.  It takes between 30 minutes and 2 hours depending on the stone and your anatomy, and can be very simple or quite complex.

The procedure first requires the doctor to look inside your bladder and to put in a special guide wire to allow the ureter to be entered.  X-rays may be done prior to the actual procedure to locate the stone, and the procedure is done with the aid of real-time x-ray (called fluoroscopy).  Depending on the location of the stone, either a shorter semi-rigid scope, or a longer flexible ureteroscope is then inserted into the ureter until the stone is located.

Occasionally the ureter must be dilated with a special balloon to allow the scope to be inserted. 

The ureteroscope is a special, very thin instrument used to look directly at and visualize the inside of the ureter. Some ureteroscopes are flexible like a small, very long straw. Others are more rigid and firm. Overall more than 400 ureteroscopic procedures are performed annually in our center.