URS Surgery for Kidney Stones: Procedure, Recovery & Success Rates
What is URS? (Ureteroscopy full form and basics)
URS stands for Ureteroscopy. It is a minimally invasive procedure used to diagnose and treat stones in the ureter (the tube connecting the kidney to the bladder). A thin, flexible or semi‑rigid scope (about 2‑3mm diameter) is passed through the urethra, into the bladder, and then up into the ureter. Once the stone is visualised, a holmium laser fibre is used to fragment it into dust or small pieces that pass naturally. No incisions are made – the entire procedure is through natural body openings.
URS is the gold standard for stones in the mid and lower ureter, and also very effective for upper ureter stones. At Vivekananda Hospital, we perform over 300 URS procedures annually with a stone‑free rate exceeding 95% for stones <15mm.
When is URS needed – stone size and location
According to 2025 EAU guidelines, URS is indicated for:
- Ureteral stones >6mm that are unlikely to pass spontaneously.
- Ureteral stones of any size causing persistent pain, obstruction, or infection.
- Stones that have failed ESWL (shock wave lithotripsy).
- Patients who prefer a single, definitive procedure over multiple ESWL sessions.
- Lower ureter stones (where ESWL has lower success).
- Patients with bleeding disorders (URS is safer than ESWL).
For stones <6mm in the lower ureter, a trial of medical expulsion therapy (tamsulosin) is reasonable. However, many patients choose URS for faster relief.
Step‑by‑step URS procedure (with laser)
Here is exactly what happens during URS at Vivekananda Hospital:
- Pre‑operative preparation: Fasting for 6 hours. Urine culture to rule out infection. Antibiotics given 1 hour before. Blood thinners stopped 5‑7 days prior.
- Anaesthesia: Spinal or general anaesthesia. You feel no pain.
- Cystoscopy (bladder exam): A small scope is first passed into the bladder to inspect it and locate the ureteric opening.
- Guidewire placement: A thin guidewire is passed up the ureter past the stone. This ensures safe passage for the ureteroscope.
- Ureteroscope insertion: The ureteroscope (semi‑rigid or flexible) is passed alongside the guidewire up to the stone.
- Stone visualisation: High‑definition camera shows the stone’s exact size, location, and composition.
- Laser lithotripsy: A 200‑micron holmium laser fibre is advanced through the scope. The laser is fired at the stone, breaking it into tiny fragments (<1mm) or dust.
- Fragment removal (optional): Larger fragments are grasped with a nitinol basket and removed. Dust is left to pass naturally.
- Stent placement (often): A double‑J stent is placed to prevent obstruction from oedema or residual fragments. It stays for 7‑14 days.
- Recovery: You are moved to the recovery room. Most patients are walking within 6 hours and go home the same day or next morning.
Total procedure time: 30‑60 minutes for a single stone.
Success rates by stone size and location
Based on 2025 data from major urology centres, including Vivekananda Hospital:
| Stone size | Location | Stone‑free rate (1 session) |
|---|---|---|
| 5‑10 mm | Any ureter | 95‑98% |
| 11‑15 mm | Mid/lower ureter | 90‑95% |
| 11‑15 mm | Upper ureter | 85‑90% |
| 16‑20 mm | Any ureter | 75‑85% (may need 2 sessions) |
For stones <15mm, URS has a higher single‑session success rate than ESWL (95% vs 70‑80%).
Recovery timeline and stent management
Here is what to expect after URS:
- Day of surgery: You wake with mild burning on urination. Pink urine is normal. You can eat and drink within a few hours. Most patients walk and go home same‑day.
- Day 1‑3: Blood in urine clears. Stent (if placed) causes urgency, frequency, and flank pain when urinating – this is normal. Take tamsulosin as prescribed. Return to desk work.
- Day 4‑7: Pain is minimal. Stent discomfort continues but is manageable. Avoid heavy lifting >5kg.
- Day 8‑14: Stent removal in clinic (takes 1 minute, mild stinging). Immediate relief. Full normal activity resumes.
URS cost in India (Vivekananda Hospital)
At Vivekananda Hospital, Hyderabad (2026 rates):
- URS with laser (including stent): ₹45,000 – ₹70,000
- URS without laser (basket extraction only – rare): ₹30,000 – ₹45,000
- Additional costs: Pre‑op tests (₹2,000‑3,000), medications (₹1,000‑2,000), stent removal (₹2,000‑5,000 if not included).
- Insurance: Cashless facility available with most Indian insurers.
Corporate hospitals charge ₹80,000‑1,20,000 for the same procedure. Small nursing homes may quote less but often lack modern laser equipment.
Interactive FAQ – URS surgery for kidney stones
The procedure itself is painless under anaesthesia. Afterward, most patients have mild to moderate discomfort (2‑4/10) from the stent, not the surgery. This resolves after stent removal.
30‑60 minutes for a single stone. Complex cases (multiple stones, impacted stones) may take 90 minutes.
No. URS is performed through the urethra – no incisions, no external scars.
Not always. For uncomplicated procedures with complete stone clearance and no ureteral trauma, stents can be omitted. However, most patients receive a stent for 7‑14 days to prevent obstruction from oedema or residual fragments.
Success rate is 95‑98% after one session. It is the best treatment for that location.
For desk jobs, yes after 2‑3 days. For physical labour, wait until after stent removal (7‑14 days).
URS typically refers to rigid or semi‑rigid ureteroscopy for stones in the ureter. RIRS (Retrograde Intrarenal Surgery) uses a flexible scope to reach stones inside the kidney. Both use a laser. At many centres, “URS” is used broadly.
At Vivekananda Hospital, URS costs ₹45,000‑70,000 (about $550‑850 USD). In the USA, the same procedure costs $12,000‑25,000. In the UK (private), £4,000‑7,000.
Yes, but it is usually staged (one side at a time) to reduce anaesthesia time and complication risk. Simultaneous bilateral URS is possible for select patients.
Disclaimer: URS is a highly effective and safe procedure for ureteral stones. If you have a stone causing pain or obstruction, consult a urologist at Vivekananda Hospital to discuss URS. Do not delay – untreated stones can damage your kidney.