Laser lithotripsy is a procedure that uses a laser to break up stones in your urinary tract. This includes your bladder, kidneys, ureters (tubes that carry pee from your kidneys to your bladder) and urethra (the tube that your pee goes through to leave your body).

Laser lithotripsy is often performed by a urologist during a ureteroscopy. They’ll insert a flexible laser fiber through a scope (a long tube with a camera on it) into your urinary tract to break up stones. They’ll remove the stone fragments with a small basket or other instruments. Providers don’t need to make any incisions (cuts in your skin) to perform this type of surgery.

Sometimes, lasers are also used to break up stones that a provider removes during a percutaneous nephrolithotomy, a procedure that remove kidney stones through an incision in your back.

Laser lithotripsy is usually done during a minimally invasive procedure. It’s not considered major surgery.

Your provider will give you instructions on how to prepare for laser lithotripsy. Following their directions closely can reduce your risk of complications. Before laser lithotripsy, your provider may ask you to:

Make sure you tell your provider about all the medications you take, including over-the-counter (OTC) and herbal supplements.

Sometimes during a scheduled lithotripsy, a provider has to place a stent to widen your ureter and reschedule the procedure for two to three weeks later.

During a laser lithotripsy performed with ureteroscopy, a provider will:

• Put you under general anesthesia so you’ll be asleep during the procedure.
• Insert a scope into your urethra.
• Put a fiber through the scope with a laser on the end.
• Break up the stone with the laser.
• Collect the pieces of the stone in a basket.
• Place a temporary tube (ureteral stent) that allows pee and small pieces of the stone to leave your body. Your provider will remove the stent at a later date (usually days to weeks later).
• Remove the scope.

Laser lithotripsy usually takes one to two hours.

Since you’ll be under anesthesia, you shouldn’t feel pain during the procedure. You may have some pain or discomfort after the procedure.

Advantages of laser lithotripsy over shock wave therapy include:

• Higher success rates.
• A lower chance of stone fragments blocking your ureter (steinstrasse).
• It’s less limited by location, hardness or size of stones.
• It’s effective on multiple stones.
• It can be used if you’re on blood thinners or pregnant.

After laser lithotripsy, it’s common to experience:

• Pain
• Difficulty peeing
• Blood in your pee (hematuria)
• Nausea and fatigue immediately after having anesthesia.

Complications of laser lithotripsy include:

• Ureter injury.
• Urinary tract infection (UTI).
• Stone fragments blocking your urinary tract.