Hospital Surgery · University Urology, PC
Cystoscopy with Holmium Laser Lithotripsy & Possible Stent Placement
Surgical preparation guide for kidney stone surgery using laser fragmentation through a scope — also called ureteroscopy with laser lithotripsy.
Your surgery date and arrival time
Your surgery date and arrival time are listed in the written instructions provided by our office. If you have any questions about your date, arrival time, or where to go, please contact our office at (865) 305-9254 or the pre-op RN directly at (865) 440-1579 to clarify before your surgery day.
Please refer to the driving & parking instructions for this appointment
See the Getting to UTMC page for directions, parking, and registration instructions.
Pre-Anesthesia Testing
Pre-Anesthesia Consultation & Testing (PAT)
Before your surgery, you will have a Pre-Anesthesia Testing appointment at UTMC. This appointment ensures the day of surgery runs smoothly and safely.
What happens at your PAT appointment
- Full health history and physical exam
- Necessary lab work
- EKG and Chest X-Ray if age or medical conditions require
- Medication review — especially blood thinners and GLP-1 medications
What to bring
- Photo ID and insurance cards
- Complete medication list with dosages and timing (prescription and over-the-counter)
- Names and phone numbers of all specialists and your primary care physician
What to tell your doctor
- Any personal or family history of bleeding disorders or anesthesia reactions
Your PAT appointment date and time
Your Pre-Anesthesia Testing date and time are listed in the written instructions provided by our office. If you have any questions about your PAT appointment, please contact our office at (865) 305-9254 or the pre-op RN at (865) 440-1579.
Pre-Surgery Instructions
Medications & Fasting
GLP-1 medications (Ozempic, Wegovy, Mounjaro, Zepbound, etc.)
Stop 7 days prior to surgery.
SGLT-2 medications (Jardiance, Invokana, Farxiga, Brenzavvy, etc.)
Stop 3 days prior to surgery.
Herbal medications and supplements
Stop 7 days prior to surgery.
All other prescription medications
Continue unless directed otherwise. Take approved medications on the morning of surgery with a small sip of water.
Fasting Instructions
Nothing to eat or drink for 8 hours before your arrival time
This includes no gum chewing or hard candy. Follow this rule strictly — eating or drinking before surgery may require postponing your procedure.
Blood thinners: do not stop without contacting your prescribing provider
If you have been prescribed aspirin or blood thinners by a cardiologist or other physician, contact that provider before making any changes. Do not stop on your own. Examples include: Warfarin (Coumadin), Plavix, Lovenox, Xarelto, Eliquis, and over-the-counter aspirin. If your blood thinner cannot be stopped for the required timeframe, contact your surgeon to discuss.
Day of Surgery
Hygiene & Logistics
Hygiene
Shower the night before and the morning of surgery using an antibacterial soap. Do not use lotions, powders, or deodorant on the day of surgery.
What to bring
Photo ID, insurance card, and your complete medication list. Leave all valuables and jewelry at home — your driver will be responsible for belongings while you are in surgery.
Driver required
You must arrange for a responsible adult to drive you home. Public transportation and ride shares (Uber, Lyft, etc.) are not permitted unless accompanied by a responsible adult.
Surgery time may change
The time of your surgery may change. If your scheduled time changes, the facility will contact you. Please plan to be available for surgery at any time on your scheduled surgery date.
About the Procedure
What Happens During Surgery
How the procedure works
Once you are asleep under general anesthesia, a small flexible scope is passed through the urethra and bladder into the ureter — the tube that carries urine from the kidney to the bladder. The scope is advanced until the stone is located. A laser is used through the scope to break the stone into small fragments.
Stent placement
A stent (a small flexible tube) will likely be placed to allow stone fragments to pass in the urine. A stent may also be placed if swelling, inflammation, or narrowing is found in the ureter. In approximately 5% of cases the stone cannot be accessed due to a narrow ureter — in that case a stent is placed and a second surgery is scheduled to treat the stone.
Recovery
What to Expect After Surgery
Urinary burning
A burning sensation when urinating is common and temporary.
Blood in urine
Small amounts of blood in the urine are expected. This should improve within a few days.
Urinary frequency
You may feel the need to urinate more frequently than normal.
Stent discomfort
If a stent was placed, mild back or flank discomfort when urinating is common. Your stent removal appointment will be scheduled before discharge.
After Surgery
When to Call Your Doctor
Contact your care team if you experience any of the following after discharge:
Fever
Temperature over 101°F
Wound concerns
Redness, warmth, swelling, or drainage from the incision or surgical site
Breathing / chest
Shortness of breath or chest pain
After hours
Call (865) 305-9254 and follow prompts for the on-call provider. For emergencies, go to your nearest ER or call 911.
University Urology & UTMC Contacts
Questions About Your Stone Surgery?
Contact our office or message us through Klara. For day-of-surgery questions, call Leah directly at (865) 440-1579.