Medical Oncologist
CION Cancer Clinics
Ureteroscopy and laser ablation, explained | CION Cancer Clinics
Ureteroscopy is a look up the ureter and into the kidney with a very thin telescope passed through the urethra and bladder, with no cuts on the outside. If a small, low-grade tumour is found, a laser fibre passed through the same telescope can burn it away in the same sitting. It is usually a day-case or one-night stay, often with a soft stent left in for a short time afterwards. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- What is ureteroscopy with laser ablation?
- What happens on the day?
- What should you expect afterwards?
- Which words will you see, in plain language?
- Four things families tell us, and what is actually true
- Who does this not suit, and what can this page not tell you?
- Common questions about ureteroscopy and laser
The short answer
What is ureteroscopy with laser ablation?
Ureteroscopy means passing a very thin telescope through the urethra and bladder, up the ureter and into the kidney, to look at the lining from the inside. Laser ablation means burning away a tumour with a fine laser fibre passed through that same telescope. There are no cuts on the outside, and the two are often done in one sitting.
What it is used for
Two jobs. The first is diagnosis: seeing the tumour, taking small samples, and collecting urine from the kidney for a cell test, so the team knows whether the tumour is low grade or high grade. The second is treatment, for a small, low-grade tumour that can be reached and burned away while the kidney is kept.
What it is not
It is not a replacement for removing the kidney and ureter when the tumour is high grade, large, or in several places. In those cases the telescope is used to confirm the diagnosis, and the bigger operation follows. Ablation on its own is offered when the tumour is low risk, or when the kidney must be kept whatever the risk.
This page explains the procedure. It cannot tell you whether your tumour is one the laser can treat. Your biopsy, urine cell test and scan decide that, read together by your team.On the day
What happens on the day?
Before you go in
A urine test is checked beforehand, because the procedure is not done while there is an infection. You will be asked not to eat for some hours. Tell the team about blood thinners; do not stop them on your own.
Anaesthetic
Usually a general anaesthetic, sometimes a spinal that numbs you from the waist down. You are positioned with your legs supported, and a thin telescope goes through the urethra into the bladder first.
Up the ureter
A soft guidewire is passed up the ureter, and a flexible telescope follows it into the kidney. X-ray guidance shows where the tip is. The surgeon looks at every part of the lining they can reach.
Sampling and laser
Tiny forceps or a basket take samples of the tumour. If the plan is to treat, the laser fibre is passed through the scope and the tumour is burned away in layers until the base looks clear.
Stent and going home
A soft plastic tube is often left in the ureter so swelling does not block the kidney. Most people go home the same day or the next morning, with a date to have the stent removed.
Not sure whether this applies to you?
Ask an oncologistThe first days
What should you expect afterwards?
Most of this is the stent, not the laser.
Pink urine
A tinge of blood in the urine is normal for some days, and can come and go while the stent is in. Drink well. Bright red urine with clots that does not clear needs a call.
Burning and urgency
The lower end of the stent sits in the bladder and irritates it, so you may need to pass urine often and feel a sting as you finish. This eases once the stent is out.
An ache in the flank
When you pass urine, some flows back up the stent to the kidney and gives a dull ache in the side. It is unpleasant but expected. Simple painkillers as your team advises usually settle it.
Helps
- Emptying the bladder before it is very full
- Not lifting heavy weights
Tiredness
An anaesthetic and a disturbed night leave most people flat for a day or two. Office work is usually possible within days; heavy physical work needs a word with your team first.
The stent must be removed on the date given. A forgotten stent hardens and becomes hard to take out.
!
One thing that cannot wait
A fever with shivering in the days after ureteroscopy, especially with pain in the side, can mean infection trapped behind a swollen kidney. Go to the nearest emergency department the same day and say you have had a telescope procedure on the kidney and may have a stent. Do not wait for the morning, and do not treat it at home with antibiotics left over from before.
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On your report
Which words will you see, in plain language?
- Ureteroscopy
- Looking up the ureter with a thin telescope. Often shortened to URS on your notes.
- Flexible and rigid
- Two kinds of telescope. The rigid one is used low in the ureter, the flexible one bends to reach inside the kidney.
- Holmium laser
- The laser most often used. It works only a short distance from the fibre tip, so it burns the tumour without going deep.
- Ablation
- Destroying the tumour in place rather than cutting it out. Nothing is left to send for a full examination, which is why samples are taken first.
- DJ stent
- A soft plastic tube curled at both ends that keeps the ureter open from kidney to bladder while swelling settles.
- Access sheath
- A slim tube placed in the ureter so the telescope can pass in and out easily during the procedure.
Commonly believed
Four things families tell us, and what is actually true
"No cut means no risk."
The risks are smaller than open surgery, not absent. The ureter wall is thin and can be scratched or, rarely, torn. A narrowing can form later where the laser worked. Infection behind a blocked kidney is the one that needs same-day care.
"The laser removed it, so no more checks are needed."
The tumour that was treated is gone. The lining that grew it is still there, and new tumours in it are common. A second look with the telescope some months later, and regular checks after that, are part of the treatment, not an optional extra.
"The stent can stay in as long as it is comfortable."
A stent left too long becomes coated in hard deposits and can be very difficult to remove. It has a removal date for that reason. Keep the appointment even if you feel fine.
"They only looked and did not treat, so something went wrong."
A first ureteroscopy is often for diagnosis only. The surgeon needs the grade from the samples before deciding whether the laser is the right treatment or whether the kidney should come out.
Being straight with you
Who does this not suit, and what can this page not tell you?
Laser ablation does not suit a high-grade tumour in someone with two healthy kidneys, a large tumour, several tumours, or one the telescope cannot reach in full. It does not suit anyone who cannot come back for the follow-up looks. And it is not the right first step if the scan already shows the tumour growing through the ureter wall.
What the laser cannot do
It cannot tell how deep a tumour goes, because it destroys tissue rather than removing it whole. Samples taken through a telescope are tiny and can under-read the grade. That is why a clear result after ablation is never treated as the final word, and why the team keeps looking.
What to ask your centre
Ask whether they do ureteroscopic laser treatment for upper tract tumours and how often. Ask what the plan is if the samples come back high grade. Ask when the second look will be and what the follow-up schedule looks like over the years. Ask how the stent will be removed and when.
Stent removal is a quick clinic visit at some centres and a short anaesthetic at others. Ask, so you can plan the day.Questions we are asked
Common questions about ureteroscopy and laser
Does it hurt?
Not during the procedure, because you are asleep or numbed from the waist down. Afterwards, the stent causes most of the discomfort: a sting when passing urine and an ache in the side. This is expected and settles once the stent is removed.
How long does it take, and will I go home the same day?
Usually under an hour in theatre, longer if the laser is used on a larger tumour. Most people go home the same day or the next morning once they are passing urine comfortably and have no fever.
What is the stent, and how is it taken out?
A soft plastic tube from kidney to bladder that keeps urine flowing while swelling settles. Some are left with a thread that hangs outside so they can be pulled in clinic. Others are removed with a short telescope look into the bladder. Your team will say which, and give you the date.
Can the laser treat any tumour?
No. It is for small, low-grade tumours the telescope can reach and see all round. Large tumours, several tumours, high-grade tumours, and ones tucked into a corner of the kidney are usually better treated by removing the kidney and ureter. The samples and scan decide.
What if the samples come back high grade?
Then the laser is usually not enough, and your team will talk to you about removing the kidney and ureter, unless you have only one kidney or your kidney function is poor. That conversation should happen before any further laser treatment is planned.
Can passing the telescope spread the cancer to the bladder?
Studies on this are mixed. New bladder tumours are common after any upper tract cancer, whether or not a telescope was used, because the bladder shares the same lining. Some teams give a single dose of chemotherapy into the bladder afterwards to lower that chance. Ask whether yours does.
Will I need this done again?
Almost certainly, at least once. A second look some months after laser treatment checks that nothing was missed. If the tumour returns as a small low-grade growth, it is often treated again the same way. Repeat looks continue at intervals for years.
Is it covered by Aarogyasri or insurance?
Often, when it is part of an approved cancer treatment plan rather than a standalone request. Aarogyasri, CGHS, ECHS and EHS are accepted, and most cashless insurers are empanelled. Call the helpline with your card details and we will check your specific cover.
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Sources
- National Cancer Institute — Transitional Cell Cancer of the Renal Pelvis and Ureter Treatment (PDQ) - Patient Version
- Cancer Research UK — Kidney cancer
- American Cancer Society — Bladder cancer
- NHS — Cystoscopy
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Kidney-sparing surgery for upper tract tumoursWhere laser treatment fits among the optionsUpper tract urothelial cancer explainedThe disease the telescope is looking forNephroureterectomy: what is removedThe operation when the laser is not enoughDrains, tubes, lines and cathetersLiving with a stent or catheterAnaesthesia for cancer surgeryGeneral versus spinal, and what to expect
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Been offered a telescope procedure?
Send us the scan and any biopsy report, or call the helpline. A surgical oncologist will explain what is planned and what to ask your centre. One helpline serves every CION centre.