Private Kidney Stone Removal (Ureteroscopy)

1. Confirm your diagnosis. Most patients start with a family doctor or specialist who confirms that  surgery is advisable. A private surgeon can also confirm the diagnosis if needed.
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2. Research.
   • You can find surgeons in Vancouver, British Columbia; Calgary, Alberta; Toronto, Ontario; and Montréal, Québec on our app, and review qualifications, as well as pricing.
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3. Schedule an initial consultation. Most surgeons offer in-clinic and online consults.
   • Consultations are usually booked within days or a few weeks.
   • Note: expect a consultation fee between $150 - $350.
   • We recommend booking 2 - 4 consultations with different surgeons to better understand your options.
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4. Consultation. The surgeon will review your condition, symptoms, and any previous treatments or diagnostics, such as x-rays or MRIs.
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5. ‍Post consultation. The surgeon will then review your case and provide surgical (and non-surgical) options based on your needs; review the risks and expected outcomes; and present pricing and scheduling options.
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6. Schedule your surgery date. Once you confirm the procedure and payment, the clinic will schedule your surgery—generally within a few weeks.

Ureteroscopy with laser: about 45–90 minutes of operating time (one side). Plan a few extra hours for check‑in, anesthesia, and recovery.

Shock Wave Lithotripsy: about 30–60 minutes. Often outpatient.

Percutaneous nephrolithotomy (PCNL/mini‑PCNL): 1.5–3 hours for larger stones; usually involves an overnight stay.

Basic steps

Check‑in and plan

• You meet the team, review scans (CT/ultrasound), and confirm which procedure you’re having and which side.

Anesthesia

• URS/PCNL: usually general anesthesia (you’re asleep).
• ESWL: sedation or light anesthesia; sometimes just pain medicine.

Position and prep

• You’re positioned safely; monitors and an IV are placed. The area is cleaned and draped.

Camera or shock setup

• URS: A tiny scope goes through the urethra → bladder → ureter/kidney. No cuts on the skin.
• ESWL: You lie on a special table; the machine targets the stone using X‑ray or ultrasound.
• PCNL: A small incision in the back creates a tunnel into the kidney; a camera and tools go through this tract.

Break and clear the stone

• URS: A laser breaks the stone; pieces are removed with tiny baskets or left small enough to pass.
• ESWL: Focused shock waves crack the stone into sand‑like bits you can pee out.
• PCNL: The surgeon breaks and suctions out large stones directly.

Stent or drain (if needed)

• URS/PCNL: A temporary ureteral stent (soft tube) may be placed to keep urine flowing and reduce swelling.
• ESWL: Usually no stent unless there’s a risk of blockage.

Close up and instructions

• URS: No external stitches. PCNL: small back incision closed with a stitch or glue. ESWL: no incisions.
• You wake up in recovery, get pain/meds instructions, and a plan for follow‑up and possible stent removal. Most URS/ESWL cases go home the same day.

Everyone heals differently—follow your surgeon’s plan. Taking the instructions seriously usually means a smoother recovery.

In general, what to expect

Week 1

• Reality check: crampy side/back pain, burning when peeing, pink/red urine, and feeling like you need to pee a lot—especially if you have a stent. Not fun, but common.
• Goals: control pain, keep urine flowing, hydrate.
• Activities: drink plenty of water; short walks a few times a day; avoid heavy lifting/straining. Keep any dressing (PCNL back incision) clean and dry. Use meds as prescribed (pain, bladder spasm medicine if given).

Weeks 2–3

• Still annoying but improving.
• Goals: settle irritation and get back to normal routines.
• Activities: increase walking; light daily tasks; most people return to desk/school within a few days (URS/ESWL) or ~1–2 weeks (PCNL). Urine should clear; burning and urgency fade.

Stent removal (if placed)

• Timing is usually 3–14 days after ureteroscopy, sometimes longer after PCNL. The removal is quick. Expect a day of extra urgency or side pain afterward.

Weeks 4–6

• The steady phase.
• Goals: feel close to normal; resume regular activity as cleared.
• Activities: back to usual exercise when approved. If you had PCNL, the small back incision is typically healed by now.

Red flags—call your care team or go to urgent care/ER

• Fever or chills, severe or worsening back/side pain not relieved by meds
• Vomiting with inability to keep fluids down
• Urine not passing or suddenly stops (possible blockage)
• Heavy bleeding (soaking pads or cherry-red urine that doesn’t lighten)
• Chest pain, shortness of breath, or calf swelling/pain

In Canada, private urology clinics usually charge:

• Shock Wave Lithotripsy: $2,500–$6,000+
• Ureteroscopy: $6,000–$16,000

In the United States

• Shock Wave Lithotripsy: CA$3,200–$11,000+
• Ureteroscopy: CA$8,100–$17,000

Prices vary by province/clinic, stone size/location, anesthesia, and whether a stent is placed. Always request a written, itemized quote.

What’s usually included

• Surgeon fee, anesthesia team, and facility/OR fees
• Standard disposables, laser use (for URS), and immediate recovery care
• Basic follow-up visit(s); sometimes initial imaging to confirm clearance

What’s often not included

• Pre-op imaging/labs done outside the clinic (CT, KUB, ultrasound)
• Extra OR time beyond the booked block, unplanned admission, or additional procedures
• Stent removal visit (sometimes separate), post-op prescriptions, and supplies
• Repeat ESWL sessions or secondary procedures if fragments persist
• Travel and accommodation (if out-of-province/state)
• Prevention workup (24‑hour urine, metabolic labs) after surgery

Choosing your surgeon is one of the biggest benefits of going private—use it to your advantage.

What to look for

Experience and volume

• Ask how many stone procedures they perform per year and their case mix:
  • Ureteroscopy with laser (flexible/rigid), ESWL (shock wave lithotripsy), mini/micro‑PCNL, standard PCNL, stent/nephrostomy management.
• Ask for outcomes in patients like you (stone size, location, density/Hounsfield units, anatomy, prior surgeries).
• High volume and standardized pathways generally mean smoother care and fewer complications.

Credentials and training

• Verify licensure with your provincial college (CPSO Ontario, CPSBC BC, CPSA Alberta, CMQ Québec, etc.).
• Look for FRCSC‑certified urologists with endourology/stone fellowship or clear high‑volume stone practice; for PCNL, confirm specific training and team experience.

Outcomes and safety

• Request stone‑free rates by procedure and size/location, unplanned ER visits, infection/sepsis rates, need for second‑look surgery, stent discomfort readmissions.
• Ask about same‑day discharge rates for URS/ESWL and overnight needs for PCNL.

Indications and alternatives

• Confirm non‑operative options were considered (trial of passage, medical expulsive therapy, hydration/pain plan).
• Clear indications = better odds of meeting expectations.

Surgical plan and techniques

• Ureteroscopy: laser settings (dusting vs fragmentation), use of access sheath, basketing strategy, plan for stent (yes/no, how long).
• ESWL: targeting method (ultrasound/X‑ray), max shocks/energy, policy on repeat sessions.
• PCNL: tract size (mini vs standard), imaging guidance, single‑step vs staged, plan for nephrostomy tube.
• Approach if multiple stones or both sides; plan if they encounter tight ureter or impacted stone.

Imaging and planning

• Use of low‑dose CT for size/location/density, KUB/ultrasound for follow‑up.
• How imaging changes the plan (e.g., high‑density stones → URS/PCNL over ESWL).

Facility accreditation

• Confirm the center is accredited (Accreditation Canada/CAAASF or provincial non‑hospital program) with appropriate equipment: modern laser, flexible scopes, ESWL unit, fluoroscopy/ultrasound, and sterile processing.
• Hospital transfer agreements for emergencies.

Aftercare integration

• Clear written instructions: hydration, pain/bladder spasm meds, when to seek help.
• Stent removal plan (where, when, included in cost).
• Prevention program: stone analysis, metabolic workup, diet advice; coordination with your local provider.

Questions to ask during your kidney stone consultation

Surgeon and surgery plan

• How many URS/ESWL/PCNL cases do you do yearly? What are your stone‑free rates for stones like mine?
• What are your recent (last 12–24 months) rates for infection/sepsis, ER returns, unplanned admissions, and need for second procedures?
• Which option do you recommend for me (and why) given stone size, location, and density?
• Will you place a stent? For how long? How is removal handled?

Anesthesia and logistics

• What anesthesia do you use for my procedure? Same‑day discharge or overnight?
• If access is difficult (tight ureter, impacted stone), what’s the backup plan?

Recovery and follow‑up

• Expected timeline to return to desk work vs manual work, exercise, and travel?
• What imaging do you use to confirm clearance, and when?
• Who do I contact after hours? Typical response time? How many follow‑ups are included, and can some be virtual?

Costs and transparency

• What exactly is included in my quote (surgeon, anesthesia, facility, laser fees, disposables, imaging during the procedure, stent placement/removal, immediate follow‑ups)?
• What could add cost (extra OR time, repeat ESWL, second‑look URS, hospital admission, unexpected imaging, nephrostomy)?
• If you need to change the plan mid‑procedure, how are consent and pricing handled?

Signals of a high‑quality program

• Publishes or shares stone‑free and complication rates by procedure and stone size/location.
• Has modern endourology equipment and standardized safety protocols (antibiotic screening, temperature/urinalysis check, time‑outs).
• Provides itemized, transparent pricing with clear inclusions/exclusions.
• Coordinates prevention workup and gives you direct post‑op contact details and a clear stent plan.