ureterolithotomy

DEFINITION of ureterolithotomy

ureterolithotomy is an open (or laparoscopic) surgical procedure in which the surgeon makes an incision directly into the ureter to extract an impacted calculus. It differs from pyelolithotomy, which incises the renal pelvis rather than the ureter, and from ureterolithotripsy, which fragments the stone endoscopically without an open incision. The approach and CPT billing depend on the stone’s location along the ureter’s course — upper third (from the renal pelvis to the crossing of the iliac vessels), middle third (between the iliac vessels and the pelvic brim), or lower third (from the pelvic brim to the bladder) — since access and technique differ by segment. After the stone is removed, the ureterotomy is closed, often over a ureteral stent or catheter to prevent stricture and support healing. Because most ureteral stones are now managed with ureteroscopy and laser lithotripsy or extracorporeal shock wave lithotripsy (ESWL), open ureterolithotomy today is reserved for large, impacted, or endoscopically inaccessible stones.

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ETYMOLOGY of ureterolithotomy

greek

Component	Origin	Meaning
o-	Greek ourētēr (οὐρητήρ), from ouron (“urine”)	“ureter” — the duct carrying urine from kidney to bladder
lith-	Greek lithos (λίθος), “stone"	"stone,” “calculus”
-otomy	Greek -tomia, from temnein (“to cut”)	Noun-forming suffix — “incision into,” “cutting”

Like its counterpart pyelolithotomy, this is a modern surgical compound assembled directly from Greek roots rather than inherited from everyday speech: o- (“ureter”) + lith- (“stone”) + -otomy (“incision into”), literally “cutting into the ureter to remove a stone.” The ureter/o- root ties this term to the broader ureteral vocabulary, including ureterolithiasis (the condition of having ureteral stones), ureteroscopy (endoscopic examination of the ureter), and ureteroplasty (surgical repair of the ureter). The shared lith- root links it to nephrolithiasis, pyelolithotomy, and lithotripsy, while -otomy is the same productive incision suffix seen in nephrotomy and cystotomy — distinct from -ectomy (“removal of an organ”) and -ostomy (“creation of a permanent opening”).

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🔀 ALIASES / ALTERNATE TERMS

• Laparoscopic ureterolithotomy (minimally invasive variant performed through small port incisions rather than an open flank incision, most often for lower-ureteral stones)
• Open ureterolithotomy (the traditional flank- or abdominal-incision approach; distinguishes it from the laparoscopic variant)

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🔗 RELATED TERMS

• pyelolithotomy — the analogous open procedure for a stone in the renal pelvis rather than the ureter; shares the same lith-/-otomy roots.
• ureteroscopy — the endoscopic, non-incisional alternative for removing or fragmenting ureteral stones; has largely replaced open ureterolithotomy for most cases.
• lithotripsy — fragmentation of a stone by laser, ultrasonic, or shock-wave energy as an alternative to surgical extraction.
• ureterolithiasis — the clinical condition (presence of a stone in the ureter) that ureterolithotomy is performed to treat.
• calculus — the mineral concretion being removed; when located in the ureter it is coded as N20.1.
• Hydroureteronephrosis — dilation of the ureter and renal pelvis from obstruction by the impacted stone; often documented alongside the indication for surgery.
• ureteral stent — a tube placed after ureterotomy closure to maintain patency and support healing during recovery.

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CODING CORNER

🏥 ICD-10-CM CODES

Ureteral and Renal Calculus (Indication for Ureterolithotomy)

Code	Description
N20.1	Calculus of ureter
N20.2	Calculus of kidney with calculus of ureter
N20.9	Urinary calculus, unspecified
N13.2	Hydronephrosis with renal and ureteral calculous obstruction

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🔧 COMMON CPT CODES (Ureterolithotomy by Ureteral Segment)

CPT Code	Description
50610	Ureterolithotomy; upper one-third of ureter
50620	Ureterolithotomy; middle one-third of ureter
50630	Ureterolithotomy; lower one-third of ureter
52352	Cystourethroscopy, with ureteroscopy and/or pyeloscopy; with removal or manipulation of calculus (endoscopic alternative)
50590	Extracorporeal shock wave lithotripsy (ESWL, non-invasive alternative)

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⚠️ Coding Note: Selection among 50610, 50620, and 50630 depends entirely on the documented anatomic segment of the ureter where the incision was made — upper, middle, or lower third — so operative reports lacking this detail should trigger a physician query before code assignment. These codes are mutually exclusive per encounter for a single stone; do not report more than one unless the operative note clearly documents separate incisions at distinct ureteral segments. Sequence the underlying calculus diagnosis (N20.1 or N20.2) as the reason for surgery, and append laterality via modifier -RT/-LT since none of the 506xx codes carry inherent laterality. As with pyelolithotomy, payers increasingly expect documentation showing why less invasive ureteroscopic or lithotripsy options were unsuitable (e.g., a large impacted stone with failed prior endoscopic attempt) before authorizing an open or laparoscopic ureterolithotomy.

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DERIVATIONS of ureterolithotomy

TABLE definition AS Definition
FROM #medterm 
WHERE length(filter(roots, (word) => econtains([[ureterolithotomy]].roots, word))) > 0 AND file.name != [[ureterolithotomy]].file.name
SORT file.name ASC

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Query functionality

TABLE definition AS Definition
FROM #medterm 
WHERE file.name != this.file.name
AND any(contains(this.definition, definition))

Med terms dictionary Appendix A Prefixes Appendix B Combining Forms Appendix C Suffixes Appendix D Suffix forms