CPT® Code 50630

An ureterolithotomy is a surgical procedure specifically designed to remove a calculus, commonly referred to as a stone, from the ureter, which is the duct that carries urine from the kidney to the bladder. This procedure is particularly focused on the lower one-third of the ureter. During the operation, a surgical incision is made in the abdomen, strategically located over the upper, middle, or lower ureter, depending on the precise location of the stone. The surgical team carefully divides the muscles of the abdominal wall and displaces the peritoneum, which is the lining of the abdominal cavity, to gain access to the ureter. Once the ureter is identified, it is meticulously dissected free from the surrounding serosa and periureteral fat to ensure a clear view and access to the stone. The surgeon then locates the stone, which may be identified by a visible bulge in the ureter or through manual palpation. To facilitate the removal of the stone, vascular loops are placed above and below the stone to immobilize it. An incision is made directly over the stone, allowing for its removal. Following the extraction, a catheter is inserted into the ureter for irrigation, ensuring that any remaining stone fragments are cleared. A soft Penrose drainage tube or suction tube is then placed to drain the ureter. The ureter incision is carefully closed, ensuring that it does not constrict the ureter, and a drainage tube is positioned before the abdominal incision is closed around the drain. This procedure is critical for alleviating the obstruction caused by ureteral stones and restoring normal urinary function.