CULLS for Kidney Stones: Advanced Ureteroscopy with Laser Lithotripsy at UPNT
At Urology Partners of North Texas (UPNT), we offer state-of-the-art kidney stone treatment, including CULLS, a highly effective, minimally invasive option for treating larger or more complex kidney stones. CULLS stands for:
- Cystoscopy
- Ureteroscopy
- Laser Lithotripsy
- Stent Placement
Your UPNT surgeon may recommend CULLS for:
- Stones in the ureter
- Hard stones that don’t respond well to shock wave treatment (ESWL)
- Stones in complex locations or those that require precision removal
CULLS allows your UPNT surgeon to access and break the stone into small fragments using advanced technology. Most patients recover quickly and resume normal activities within a few days.
CULLS vs. ESWL: Which Treatment is Right for You?
Both CULLS (ureteroscopy with laser lithotripsy) and ESWL (shock wave lithotripsy) are effective for kidney stones, but they are used in different situations based on the size and location of the stone.
When to Choose ESWL (Shock Wave Lithotripsy):
- Best for kidney stones or ureteral stones that are small to moderate in size
- Non-invasive option (no incisions or scopes required)
- Often used as a first-line treatment for straightforward stone cases
- Quick recovery with minimal downtime
When to Consider CULLS (Laser Lithotripsy):
- For stones that are too large, dense, or resistant to shock waves
- ESWL fails to fully clear the stone
- When stones are located in challenging areas or need more precision
- Preferred when a more direct approach is needed to guarantee stone clearance
Step-by-Step Breakdown of CULLS
CULLS is a combination of several steps, each performed with precision by your UPNT surgeon to ensure complete removal of the stone.
1. Cystoscopy
The first step is cystoscopy, which allows your UPNT surgeon to examine your urinary tract and access the stone.
- A cystoscope (a thin tube with a camera) is gently inserted through the urethra and into the bladder.
- This step helps confirm the stone’s location.
2. Ureteroscopy
Once the stone’s location is confirmed, your UPNT surgeon performs ureteroscopy to reach the stone in the ureter or kidney.
- A ureteroscope (a very thin, flexible scope) is passed through the bladder and into the ureter or kidney.
- Real-time imaging ensures the stone is precisely targeted without damaging surrounding tissue.
3. Advanced Laser Technology with the Moses™ Laser
At UPNT, we perform CULS (laser lithotripsy) using the Moses™ holmium laser, one of the most advanced tools available for kidney and ureteral stone removal.
Unlike older laser systems, Moses Technology delivers energy with greater precision and less stone movement, allowing your surgeon to break up stones:
- More efficiently
- With less trauma to surrounding tissue
- In less time
Whether your stone is large, dense, or located in a difficult area, the Moses laser gives us greater control — which means a smoother procedure and faster recovery for you.
Ask your UPNT surgeon if the Moses™ laser is the right choice for your stone treatment.
4. Stent Placement
Finally, a ureteral stent is placed to ensure proper drainage and prevent blockages as the stone fragments pass.
- The stent is a temporary tube placed from the bladder to the kidney to keep the ureter open.
- Most stents are removed within 1–3 weeks after the procedure.
Why Most Patients Need a Stent After CULLS
A ureteral stent plays a crucial role in preventing complications and ensuring smooth recovery after CULLS.
What Does a Ureteral Stent Do?
- Keeps the Ureter Open: Prevents swelling or stone fragments from blocking the flow of urine.
- Reduces Pain: Helps alleviate pressure in the kidney as fragments pass.
- Ensures Proper Drainage: Promotes healing by allowing urine to flow freely.
How is the Stent Placed?
The stent is placed during the procedure using cystoscopy while you’re under anesthesia, so you won’t feel a thing.
Temporary and Easy to Remove
- The stent is usually removed within 1–3 weeks.
- Removal is a quick, outpatient procedure with minimal discomfort.
Recovery and Aftercare
Most patients recover quickly after CULLS. Here’s what to expect:
- Mild Discomfort: You may experience some back pain, cramping, or blood in the urine for a few days.
- Stent-Related Symptoms: Some patients feel urinary frequency or urgency while the stent is in place.
- Hydration is Key: Drinking plenty of water helps flush out the stone fragments faster.
Your UPNT surgeon will provide personalized aftercare instructions to ensure a smooth recovery.
Frequently Asked Questions (FAQs) about Ureteroscopy with Laser Lithotripsy
Why is CULLS (Ureteroscopy with Laser Lithotripsy) used instead of or after ESWL?
How long does the CULLS procedure take?
The procedure typically takes 30–60 minutes, depending on the size and location of the stone. Larger stones may take longer to treat, while smaller stones require less time.
Is CULLS painful?
You’ll be under general anesthesia during the procedure, so you won’t feel anything. Afterward, you may experience mild discomfort or cramping, which improves within a few days.
How long will I have a stent?
Most patients have a stent for 1–3 weeks. Your UPNT surgeon will remove it during a quick, outpatient procedure.
What is the recovery time after CULLS?
A Holmium laser delivers high-energy pulses to break the stone into tiny fragments. These fragments either pass naturally or are removed with a small basket.
Why Most Patients Need a Stent After CULLS
A ureteral stent plays a crucial role in preventing complications and ensuring smooth recovery after CULLS.
What Does a Ureteral Stent Do?
- Keeps the Ureter Open: Prevents swelling or stone fragments from blocking the flow of urine.
- Reduces Pain: Helps alleviate pressure in the kidney as fragments pass.
- Ensures Proper Drainage: Promotes healing by allowing urine to flow freely.
How is the Stent Placed?
The stent is placed during the procedure using cystoscopy while you’re under anesthesia, so you won’t feel a thing.
Temporary and Easy to Remove
- The stent is usually removed within 1–3 weeks.
- Removal is a quick, outpatient procedure with minimal discomfort.
Book an Appointment for Kidney Stone Treatment
At Urology Partners of North Texas, we offer advanced kidney stone treatment options like CULLS to ensure the best outcomes for our patients.
Conveniently located in Arlington and Fort Worth, we’re here to help you find relief from kidney stones.