What Is a Ureteroscope? Parts, Sizes and Ureteroscopy Types

What is a ureteroscope used for?

The ureteroscope allows the surgeon to inspect the ureter and renal collecting system. Its most frequent use is to treat urinary stones: a laser fibre or other lithotripsy probe passes through the working channel and fragments the stone, and baskets or graspers retrieve the pieces. It is also used to biopsy or treat lesions of the upper urinary tract, to diagnose causes of bleeding, and to deal with strictures when indicated.

In some places you will also see the ureteroscope called a ureterorenoscope (URS or URSL when used for lithotripsy), a name that reflects its ability to reach the kidney. Do not confuse it with a cystoscope, which is shorter and designed for the bladder; see what is a cystoscope.

Ureteroscope parts

Every ureteroscope has an insertion shaft, a handle with connections, a working channel and an irrigation path. Flexible models add a deflection lever and a distal tip that bends. Digital models have a camera chip at the tip and a cable to the camera controller; fibreoptic models carry the image through glass fibres to an eyepiece or camera head, and a light cable connects to the light source.

Accessories around the scope matter just as much: guidewires, a ureteral access sheath, irrigation, laser fibres, baskets and graspers, and a camera system with a monitor. The access sheath is covered in ureteral access sheath guide.

• Insertion shaft and distal tip
• Handle with deflection lever (flexible models)
• Working channel and irrigation connection
• Light cable and camera cable or eyepiece
• Camera controller, light source and monitor

How big is a ureteroscope?

Ureteroscope size is given in French (Fr), where 3 Fr equals 1 mm. Modern scopes are slim, because the ureter is narrow, and the tip is usually thinner than the shaft. Sizes vary by model, so always take figures from the datasheet. For example, the Richard Wolf BOA has an 8.7 Fr shaft and a 6.6 Fr tip and fits access sheaths of 9.5 Fr or larger, while the COBRA has a 5.2 Fr distal tip, a 3.6 Fr working channel and a 2.4 Fr laser channel for fibres up to 365 µm.

More detail on how to read sizes is in ureteroscope size in French. Remember that the channel size limits the instruments and fibres you can use.

Ureteroscopy types: semi-rigid and flexible

Semi-rigid ureteroscopes are thin, sturdy and give a good image and strong irrigation flow, which suits stones in the lower and middle ureter. Flexible ureteroscopes deflect, so they can reach the upper ureter and every calyx of the kidney. Many departments own both and choose by stone location and anatomy. The comparison is expanded in flexible vs semi-rigid ureteroscope.

Flexible models can be digital or fibreoptic, reusable or single-use. The BOA and COBRA flexible sensor endoscopes are digital sensor endoscopes for the ENDOCAM Logic 4K platform, with 270° deflection up and down and Special Imaging Modes.

Handling, reprocessing and lifetime

Ureteroscopes, especially flexible ones, are precision instruments. The most common causes of damage are bending the shaft beyond its limit, firing a laser fibre while the tip is deflected, forcing instruments through the channel and rough handling during cleaning. Teach everyone who touches the scope how to carry it, how to coil the cable and how to perform a leak test.

Reusable scopes need validated cleaning and disinfection or sterilisation according to the instructions for use, and a repair plan. Keep a log of cases and repairs per scope; this data later helps you decide whether single-use options or a larger fleet make sense.

What to consider when equipping a department

Plan the camera platform first, because it determines which digital scopes you can use. Then decide on the number of scopes, reprocessing capacity, laser and sheaths, and the training of surgeons and nurses. Check that every supplier can document registration of the device with the competent UAE authority.

Beckfinity's specialists can help you configure ureteroscopy equipment. Request a quote or consultation to match scopes, camera and laser to your caseload.