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What Is Endoscopic Urology Surgery?

What Is Endoscopic Urology Surgery?

📖 5 min read Written and medically reviewed by Dr. Alhad Naragude, MBBS, MS, DrNB Urology Last updated: July 23, 2026

Endoscopic urology surgery uses small telescopes and instruments passed through a natural urinary opening or a small access tract to diagnose or treat disease without a large traditional incision. Common examples include cystoscopy, ureteroscopy for stones, TURP/HoLEP for prostate obstruction and TURBT for bladder tumours. “No skin cut” does not mean “no surgery”: bleeding, infection, urinary retention, ureteric injury, catheter/stent use and anaesthesia-related risks can still occur. Recovery is often faster than open surgery, but the expected course depends on what was treated and how extensive the procedure was.

“Endoscopic” describes how the surgeon reaches the urinary tract, not how small the medical problem is. A procedure with no skin incision can still involve bleeding, infection, a catheter, a DJ stent, anaesthesia and several days or weeks of internal healing.

What does “endoscopic” mean?

An endoscope is a narrow instrument containing a camera/light system. In urology, it can be passed through the urethra into the bladder and, with finer instruments, into the ureter and kidney.

The surgeon watches a magnified video image and passes working tools through channels in the scope.

Common endoscopic urology procedures

Cystoscopy

Inspection of the urethra and bladder. It may be diagnostic or used for biopsy, stent removal or minor treatment.

Ureteroscopy (URS/RIRS)

A small scope enters the ureter and sometimes the kidney to treat stones, strictures or selected lesions. Laser energy is often used for stone fragmentation.

TURP/HoLEP and other transurethral prostate procedures

Instruments pass through the urethra to remove or enucleate obstructing prostate tissue.

TURBT

Transurethral resection of bladder tumour removes visible bladder tumour and obtains tissue for histopathology/staging.

Endoscopic urethral procedures

Selected strictures can be incised or dilated endoscopically, although recurrence risk and indications differ from urethroplasty.

Does endoscopic surgery require anaesthesia?

Yes, depending on the procedure. Flexible diagnostic cystoscopy may use local anaesthetic gel. Operative cystoscopy, ureteroscopy, TURP or bladder tumour resection may use spinal or general anaesthesia.

The fact that there is no skin incision does not eliminate anaesthesia needs.

What instruments can be used through the scope?

Depending on the operation, the surgeon may use:

  • Graspers/baskets.
  • Laser fibres.
  • Electrosurgical loops.
  • Biopsy forceps.
  • Guidewires.
  • Stone retrieval devices.
  • Dilators.

What are the benefits of endoscopic surgery?

For suitable conditions, advantages can include:

  • No large external incision.
  • Shorter hospital stay.
  • Faster mobility and return to basic activity.
  • Less wound pain.
  • Ability to directly visualise the urinary tract.

However, some diseases are better treated by percutaneous, laparoscopic, robotic or open surgery.

What are the main risks?

Risks vary by procedure but can include:

  • Bleeding.
  • Urinary infection or sepsis.
  • Burning/frequency after instrumentation.
  • Urinary retention.
  • Urethral injury or later stricture.
  • Ureteric injury during ureteroscopy.
  • Need for a DJ stent or catheter.
  • Incomplete treatment requiring a second procedure.

Why might I wake up with a catheter?

After prostate/bladder surgery, a catheter allows urine and blood to drain while the operated tissue heals. Irrigation may be used for a period if bleeding is expected.

After simpler procedures, no catheter may be needed.

Why might I need a DJ stent?

A ureteric stent can keep urine flowing after ureteroscopy when the ureter is swollen, injured, infected or at risk of blockage. It may also be placed before definitive treatment.

Stents can cause temporary frequency, urgency, blood in urine and flank pain.

How long is recovery?

Recovery depends on the procedure. A diagnostic cystoscopy may require little downtime. Ureteroscopy may cause several days of urinary/stent symptoms. TURP/HoLEP or TURBT involves a larger internal healing surface and may require longer restrictions despite no skin incision.

When endoscopic surgery is not enough

Large complex stones may need PCNL. Long urethral strictures may be better treated by urethroplasty. Large tumours or reconstructive problems may need laparoscopic/robotic/open surgery.

“Minimally invasive” should describe the approach, not imply that it is always the best treatment.

Questions to ask before an endoscopic procedure

  • What exactly will be done through the scope?
  • Is this diagnostic, therapeutic or both?
  • Might I need a catheter or DJ stent?
  • Will tissue be sent for biopsy?
  • Is there a chance I will need a second-stage procedure?
  • What bleeding and urinary symptoms are expected afterwards?

FAQs

Is endoscopy the same as laser surgery?

No. Endoscopy describes how the surgeon reaches the urinary tract. A laser is one tool that may be used through an endoscope.

Is endoscopic surgery painless?

It usually requires anaesthesia or local numbing depending on the procedure. Some burning, urgency or stent discomfort can occur afterwards.

Can endoscopic surgery treat kidney stones?

Yes. Ureteroscopy/RIRS is widely used for ureteric and selected kidney stones. Larger/complex stones may be better treated with PCNL.

Does endoscopic surgery leave scars?

Transurethral procedures do not create external skin scars. Percutaneous endoscopy such as PCNL uses a small skin tract.

Related reading

References

Note: This information is for educational purposes only and is not a substitute for medical advice. Please consult your doctor for any symptoms.