I am posting my recent experience of having a ureteroscopy in both ureters and the subsequent stents. I hope this will help someone in just knowing what you could expect. I don't write this to scare anyone but I think it is helpful to have an account of actual experience to help make an informed decision.
I am a 54 year old male with a history of kidney stones (over 20). In my past, I've been hospitalized three times, had 6 lithotripsies ( 4 of which were successful), and 2 ureteroscopies. Some of my stones have caused horrific experiences and others have been passed without much discomfort at all. Through the years, I have focused on diet, drinking lots of distilled water, various prescriptions, and the various recommendations from urologists...but I still generate calcium oxalate stones every 2-4 years.
6 weeks ago, I felt the familiar aching beginning in my lower left back area. Knowing that it felt like a stone, I waited a couple of days to see if it would pass but it did not. Scheduled appointment with my urologist, had the x-rays and sonogram and learned that I had four stones. Since I am planning to be out of the country for a few weeks in September, I wanted to go ahead and get rid of the stones. Scheduled and had a lithotripsy but it was not successful...very frustrating. My urologist strongly recommended a ureterscopy to get the stones out. I did not have a good experience with the previous ureteroscopy but given my pending travel, this seemed the only option. So, I agreed.
The good news, they did get all the stones...and the actual procedure is under general anesthesia so there's no problem there...I keep trying to remember that. The recovery has been challenging. They put stents in both ureters and I had to have them for a week (the urologist wanted 2 weeks but I pushed for getting them out as soon as reasonably possible). Following the procedure and for three days, urinating was painful. The procedure evidently scratched the inside tissue of my urethra. To be clear, it felt like I was peeing out hot acid with ground up shards of glass in it. I found that if I sat down to pee, and pushed my fingernails in both my neck and lower calf, it helped to distract from the pain. Since you have to drink a lot, you have to pee a lot during the recovery...so you have to come up with some strategy to deal with the urination pain. The urine looked like dark cranberry juice due to the continued bleeding.
After three days, the pain lessened but it was still quite uncomfortable. The pain medications help but they don't want you to take any INSAIDS due to blood thinning so you can't take ibuprofen...which would help with the tissue relaxation. While the stents were in, I generally felt "bad". I had no energy. And the pain was similar to moderate kidney colic. Anyway...after a week, I had the stents removed.
The stent removal process is not all that bad but it's uncomfortable. I took a pain pill a couple of hours before to be prepared. They use a local anesthetic on the tip of and just inside the penis. (The last stent I had had still had the string hanging out but this time, they snipped the strings further up in my penis.) You lay down, and the urologist inserts a scope inside the penis, clamps on the end of the stent, and pulls it out. It feels odd but not overly painful. If I had to do it over again, I would recommend getting some sort of muscle relaxer or valium to relax more. The whole process of having someone stick something up your penis and deep inside your body while you're awake it just not pleasant for me. I think they should use something like nitrous oxide like the dentists use for certain procedures. In terms of blood in the urine, it cleared up within a matter of hours afterwards.
For a week after the stent removal, I still had some left kidney pain (there were three stones in the left kidney). I passed blood clots from time to time and came to learn of "clot colic". In essence, the clots can block the ureter and you experience similar pain as mild to moderate kidney colic. I managed through this with INSAIDs, heating pad, hot tub, and drinking lots of water. The previous ureteroscopy I had had was not this difficult...once the stent was removed, I had no further pain. This time, it was significantly more difficult.
If you have to have a ureteroscopy, the bottom line is that you can generally be assured they they will get the stone(s). Again, I have to focus on the procedure being successful but it honestly is difficult. The whole experience has been worse than several of my previous bouts with kidney stones. However, you need to know that the recovery is not necessarily that easy (based on my experience). You need to plan at least a couple of weeks following the removal of the stents to get over it all.