The middle and lower ureteral stones are broken through the conduit (TUL) in the operating room and it requires anesthesia. TUL is done in the operating room under general anesthesia or spinal anesthesia (from the waist down), so patients should be fasting before surgery.

In this procedure, there is no incision on the body and all acts done through the urinary tract. During TUL the surgeon puts a slim tool called ureteroscope with 2 -2/5mm in diameter in the urethra and bladder and finds the ureter and enters it. Then, this tool rises up to kidneys until it reaches to the stones. After seeing the stone, by a very fine probe hits the stone quickly and powerfully to crush it.  If the ureter is dilated, the pieces of stone can be removed by Forceps. But this is not usually necessary and the pieces of stone are left there until they come out with the flow of urine.

When the stone moves from the kidney and falls in the ureter tube, it causes the obstruction and damage to the kidneys and causes a terrible and sudden pain to the patient. In the absence of spontaneous stone passage, TUL is used to treat it.

The method of TUL

In this procedure, the stone is completely crushed and removed by Spinal anesthesia and using a very thin camera called ureteroscope in the Ureter and by direct vision using laser or lithoclast.