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extraction)","how_it_works":{"id":"H1","text":"A laser may fragment the stone without any skin cuts","source":{"url":"https://www.newcastle-hospitals.nhs.uk/services/urology/stone-surgery/","host":"newcastle-hospitals.nhs.uk","quote":"The operation does not involve any cuts in the skin and a laser may be used to fragment the stone.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},"recovery_daily":{"event":"back_to_daily_activities","min":7,"max":7,"unit":"days","label":"7 days","source":{"url":"https://my.clevelandclinic.org/health/procedures/16285-holmium-laser-lithotripsy","host":"my.clevelandclinic.org","quote":"Most people are able to return to their usual activities around a week after laser lithotripsy.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},"suits_whom":"Adults with kidney or ureteral stones, particularly lower-pole or moderate-size stones","price_from":{"status":"missing","reason":"not_collected"},"recovery":"Same-day or next-day discharge; stent symptoms if a stent is left."},{"id":"diagnostic-flexible","name":"Diagnostic flexible ureteroscopy with biopsy","how_it_works":{"id":"H1","text":"A fine telescope is passed up the ureter and into the kidney","source":{"url":"https://www.gloshospitals.nhs.uk/your-visit/patient-information-leaflets/ureteroscopy-ghpi1677_07_21/","host":"gloshospitals.nhs.uk","quote":"A specially designed fine telescope is passed through the urethra and urinary bladder up the ureter and can go all the way up to the inside of the kidney.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},"recovery_daily":{"status":"missing","reason":"no_official_source"},"suits_whom":"Suspected upper tract lesions or unexplained hematuria","price_from":{"status":"missing","reason":"not_collected"},"recovery":"Usually brief hematuria and mild discomfort."}],"alternatives":{"status":"ok","items":[{"id":"A1","text":"Your stone is small enough for shock wave treatment without surgery","name":"Shock wave lithotripsy","source":{"url":"https://www.newcastle-hospitals.nhs.uk/services/urology/stone-surgery/","host":"newcastle-hospitals.nhs.uk","quote":"An innovative and minimally invasive technique called extracorporeal shock wave lithotripsy (ESWL) is used to treat the stones without the need for surgery.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200},"operation_id":null},{"id":"A2","text":"Your stone is large and needs removal directly from the kidney","name":"Percutaneous nephrolithotomy","source":{"url":"https://www.newcastle-hospitals.nhs.uk/services/urology/stone-surgery/","host":"newcastle-hospitals.nhs.uk","quote":"Percutaneous nephrolithotomy is an operation to remove large stones (15mm or more) directly from the kidney.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200},"operation_id":null}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"diagnostic":{"status":"not_applicable"},"country":{"why":{"status":"missing","reason":"no_official_source","checked_at":"2026-11-11","next_check_at":"2027-02-09"},"travel":{"status":"ok","items":[{"id":"V1","item":"passport_validity","audience":"uk","volatile":true,"text":"The passport must have an expiry date at least 3 months after you plan to leave the Schengen area","source":{"url":"https://www.gov.uk/foreign-travel-advice/spain/entry-requirements","host":"gov.uk","quote":"have an ‘expiry date’ at least 3 months after the day you plan to leave the Schengen area (the expiry date does not need to be within 10 years of the date of issue)","tier":"official_travel","fetched_at":"2026-11-11","http_status":200}},{"id":"V2","item":"medicines","audience":"all","volatile":false,"text":"Carry prescription medication in its original packaging, along with your doctor's prescription","source":{"url":"https://travel.state.gov/content/travel/en/international-travel/International-Travel-Country-Information-Pages/Spain.html","host":"travel.state.gov","quote":"Always carry your prescription medication in original packaging, along with your doctor’s prescription.","tier":"official_travel","fetched_at":"2026-11-11","http_status":403}},{"id":"V3","item":"prescriptions","audience":"us","volatile":false,"text":"Medications that require a prescription in the United States also require a local doctor's prescription in Spain","source":{"url":"https://travel.state.gov/content/travel/en/international-travel/International-Travel-Country-Information-Pages/Spain.html","host":"travel.state.gov","quote":"Medications requiring prescriptions in the United States also require a local doctor’s prescription in Spain.","tier":"official_travel","fetched_at":"2026-11-11","http_status":403}},{"id":"V4","item":"ghic","audience":"uk","volatile":false,"text":"A GHIC or EHIC is needed to get medically necessary state healthcare in Spain","source":{"url":"https://www.gov.uk/foreign-travel-advice/spain/health","host":"gov.uk","quote":"To get medically necessary state healthcare in Spain, you need a Global Health Insurance Card ( GHIC ) or a European Health Insurance Card ( EHIC ).","tier":"official_travel","fetched_at":"2026-11-11","http_status":200}},{"id":"V5","item":"hospital_payment","audience":"all","volatile":false,"text":"Private hospitals usually require payment or proof of insurance or funds before admitting a patient","source":{"url":"https://travel.state.gov/content/travel/en/international-travel/International-Travel-Country-Information-Pages/Spain.html","host":"travel.state.gov","quote":"Private hospitals usually require payment or proof insurance or funds before admitting a patient.","tier":"official_travel","fetched_at":"2026-11-11","http_status":403}},{"id":"V6","item":"emergency_number","audience":"all","volatile":false,"text":"Dial 112 and ask for an ambulance","source":{"url":"https://www.gov.uk/foreign-travel-advice/spain/health","host":"gov.uk","quote":"Dial 112 and ask for an ambulance.","tier":"official_travel","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-11","next_check_at":"2026-12-11","version":1},"other_countries_with_page":["azerbaijan","germany","greece","india","israel","italy","republic-of-korea","romania","thailand","turkey","ukraine"]},"often_combined_with":{"status":"missing","reason":"not_collected"},"reviews":{"avg_rating":5,"count":3,"scope":"clinic","rating_scale":5,"pros":{"status":"missing","reason":"not_collected"},"cons":{"status":"missing","reason":"not_collected"}},"current":{"seo_text":"<p>The cost of flexible ureterorenoscopy (URS) in Spain typically ranges <strong>from _price_from_ to _price_to_</strong>. Pricing depends on the clinic, surgeon experience, whether the procedure is unilateral or bilateral, and the complexity of stone removal. In the United States, the average cost is <strong>_price_compare_us_average_</strong> (per AUA). This means URS in Spain is about _price_percent_discount_% less than in the U.S.</p><p>Most Spanish clinics include the initial consultation, pre-op blood tests, post-op medication, follow-up visits, English-speaking staff, personalized care plans, and meals during clinic stays. U.S. prices often cover only the procedure itself, with extra charges for anesthesia, medications, and follow-ups. Always confirm exactly what’s included with your chosen clinic.</p>","faq":[{"q":"What is a Flexible Ureterorenoscopy (URS)?","a":"<p>Flexible Ureterorenoscopy (URS) is a minimally invasive procedure using a flexible fiber-optic scope to treat kidney stones and urinary tract conditions. Surgeons navigate the urethra and bladder into the kidney without incisions. This technique allows for laser lithotripsy to fragment stones smaller than 2 cm.</p> <ul> <li><strong>No-incision surgery:</strong> Surgeons access the upper urinary tract through natural openings instead of external cuts.</li> <li><strong>Stone treatment:</strong> Laser fibers break stones while small baskets retrieve fragments for immediate removal.</li> <li><strong>Hospital stay:</strong> Most procedures are outpatient or require only a single night for observation.</li> <li><strong>Recovery timeline:</strong> Initial discomfort peaks within 48 hours and urinary burning eases within 3 days.</li> </ul> <p><strong>Bookimed Expert Insight:</strong> While basic packages starting at _op_1050_price_from_ cover the surgery, the presence of advanced robotics and JCI-accredited facilities like Hospital Ruber Internacional in Madrid ensures high safety standards. When choosing a specialist, look for doctors like Navarro Vilches who have specific training at institutions like Memorial Sloan-Kettering to ensure mastery over stone management and complex oncology cases.</p> <p><strong>Patient Consensus:</strong> Expect temporary blood in urine and a strong urge to pee immediately after. Many recommend requesting a string for stent removal to make the follow-up process quick and painless.</p>"},{"q":"Is flexible ureteroscopy better than rigid?","a":"<p>Flexible ureteroscopy is not inherently better than rigid ureteroscopy but offers superior access for kidney stones. While rigid scopes excel in the lower ureter, flexible instruments navigate the entire kidney and upper urinary tract. Surgeons use laser lithotripsy through flexible scopes to fragment stones in complex locations.</p> <ul> <li><strong>Navigation reach:</strong> Flexible scopes access the renal pelvis and calyces for high stones.</li> <li><strong>Trauma reduction:</strong> Maneuverability allows the scope to follow natural curves, reducing ureteral injury.</li> <li><strong>Success rates:</strong> Laser lithotripsy via flexible scopes achieves approximately 90% success for kidney stones.</li> <li><strong>Fragment removal:</strong> This endoscopic method eliminates the need to pass stone fragments naturally.</li> </ul> <p><strong>Bookimed Expert Insight:</strong> Spain ranks among the top two destinations for urology due to medical infrastructure. Facilities like Hospital Ruber Internacional utilize JCI-accredited standards, which often correlate with high technology integration. Surgeons like Dr. Navarro Vilches at Quirónsalud Marbella often prefer flexible URS for complex cases. This choice specifically avoids the need for more invasive percutaneous procedures (PCNL) for kidney stones.</p> <p><strong>Patient Consensus:</strong> Expect temporary discomfort from the internal stent, which usually peaks within 48 hours. Patients suggest requesting a stent with a string to avoid an additional doctor visit for removal.</p>"},{"q":"How are kidney stones removed during the procedure?","a":"<p>Flexible ureterorenoscopy in Spain removes kidney stones using a thin, steerable telescope passed through the urethra. Surgeons locate stones in the urinary tract without any external incisions. They use lasers to fragment large stones or specialized baskets to retrieve small debris directly.</p> <ul> <li><strong>Retrograde access:</strong> The scope enters through the natural urinary opening without skin incisions.</li> <li><strong>Laser fragmentation:</strong> Surgeons use high-precision laser beams to break stones into tiny dust.</li> <li><strong>Stone retrieval:</strong> Specialized surgical baskets capture and remove fragmented pieces from the kidney.</li> <li><strong>Minimally invasive:</strong> The procedure uses flexible endoscopes to navigate complex structures within kidneys.</li> </ul> <p><strong>Bookimed Expert Insight:</strong> Spanish centers like Hospital Ruber Internacional integrate 3-Tesla MRI and JCI-accredited safety protocols. This allows surgeons like Navarro Vilches at Quirónsalud Marbella to combine flexible URS with robotic-assisted planning. This high-tech synergy ensures precise stone targeting even in anatomically difficult cases.</p> <p><strong>Patient Consensus:</strong> Patients report the flexible scope approach feels less invasive than traditional methods. Most emphasize the importance of confirming which specific laser technology the surgeon uses for fragmentation.</p>"},{"q":"Is a stent always necessary?","a":"<p>A stent is not always necessary after flexible ureterorenoscopy, though specialists recommend it in nearly 100% of cases. It prevents ureteral collapse, strictures, and life-threatening complications like urosepsis. Urologists only skip stenting during rare, uncomplicated procedures to avoid common post-operative bladder spasms and urgency.</p> <ul> <li><strong>Standard of care:</strong> Minimizes risks of post-operative swelling and kidney drainage obstruction.</li> <li><strong>Surgical specialist:</strong> Dr. Navarro Vilches at Quironsalud Marbella leads advanced urological surgery units.</li> <li><strong>Clinical accreditation:</strong> Hospitals like Ruber Internacional maintain Joint Commission International safety standards.</li> <li><strong>Material choice:</strong> Silicone or smaller diameter stents may significantly reduce patient discomfort levels.</li> </ul> <p><strong>Bookimed Expert Insight:</strong> While patients often fear stent discomfort, the real differentiator in Spain is the access to European Board of Urology (EBU) certified surgeons. Experts like Dr. Josep Torremade Barreda utilize precise flexible techniques that can reduce the duration a stent must remain in place, often shortening the standard recovery window.</p> <p><strong>Patient Consensus:</strong> Patients emphasize that while bladder urgency and burning are common, a survival kit with heating pads and high hydration is essential. Most find the removal process surprisingly quick, involving only a brief localized sensation.</p>"},{"q":"How long is the recovery time?","a":"<p>Recovery after flexible ureterorenoscopy (URS) in Spain typically takes 3 to 7 days for initial comfort. Most patients return to normal activities within 1 to 2 weeks. Complete internal healing and symptom resolution generally occur within 3 to 4 weeks, especially if surgeons place a ureteral stent.</p> <ul> <li><strong>Daily activities:</strong> Return to light work or home routines after 3 to 7 days.</li> <li><strong>Physical exertion:</strong> Avoid heavy lifting and intense exercise for at least 2 weeks.</li> <li><strong>Internal healing:</strong> Full tissue recovery typically takes 3 to 4 weeks post-procedure.</li> <li><strong>Stent discomfort:</strong> Expect flank pain or urgency for 48 hours if a stent is used.</li> </ul> <p><strong>Bookimed Expert Insight:</strong> Spanish urology centers like Hospital Ruber Internacional utilize advanced Holmium lasers and Da Vinci systems to minimize tissue trauma. Data shows centers in Marbella and Madrid often perform these as outpatient procedures. This allows international patients to transition to a hotel within 24 hours of surgery.</p> <p><strong>Patient Consensus:</strong> Expect burning during urination and wine-colored urine for the first week. Using heating pads and staying hydrated helps manage the peak discomfort during those first 48 hours.</p>"},{"q":"Who are the top urologists in Spain for this procedure?","a":"<p>Top urologists in Spain for flexible ureterorenoscopy include Dr. Navarro Vilches at Quirónsalud Marbella and Dr. Carlos Torrecilla Ortiz at Hospital HM Nou Delfos. These specialists use advanced laser lithotripsy and endoscopic techniques within JCI-accredited facilities to treat complex kidney stones and urinary pathology.</p> <ul> <li><strong>Dr. Navarro Vilches:</strong> Head of Urology in Marbella specializing in flexible ureterorenoscopy and oncological surgery.</li> <li><strong>Dr. Carlos Torrecilla:</strong> National expert in endourology with over 43 years focusing on kidney lithiasis.</li> <li><strong>Dr. Josep Torremade:</strong> Head of Andrology at Teknon specializing in robotic-assisted urological and microsurgical procedures.</li> <li><strong>Hospital Ruber Internacional:</strong> Top-tier Madrid facility ranked by Forbes, featuring dual JCI and ISO accreditations.</li> </ul> <p><strong>Bookimed Expert Insight:</strong> While many surgeons focus on general urology, choosing a specialist like Dr. Navarro Vilches matters. His dual focus on oncology and stone removal ensures comprehensive care. Our data shows Spain remains a top destination for complex endourology. Clinics here offer significant savings of _price_percent_discount_% compared to US surgical costs.</p> <p><strong>Patient Consensus:</strong> Patients often report that while the procedure is minimally invasive, stent discomfort remains a factor. Most feel significant relief from urinary symptoms within 2 to 3 days post-surgery.</p>"},{"q":"What should I look for in a Spanish urology clinic?","a":"<p>When selecting a Spanish urology clinic, prioritize facilities with Joint Commission International accreditation and surgeons holding European Board of Urology (EBU) certification. Top-tier centers in Madrid and Barcelona utilize advanced technologies like Da Vinci Xi robotic systems and digital flexible scopes for minimally invasive stone removal.</p> <ul> <li><strong>Surgeon credentials:</strong> Seek specialists with European Board of Urology (EBU) membership and specialized fellowship training.</li> <li><strong>Advanced technology:</strong> Ensure access to Da Vinci Xi robotics, Holmium lasers, and digital flexible ureterorenoscopes.</li> <li><strong>Clinical certifications:</strong> Prioritize hospitals holding Joint Commission International (JCI) or ISO 9001 quality management accreditations.</li> <li><strong>Diagnostic precision:</strong> Verify availability of 3-Tesla MRI and PET-CT scans for accurate pre-operative mapping.</li> </ul> <p><strong>Bookimed Expert Insight:</strong> Spain's elite urology units are often led by experts with prestigious US training. Dr. Josep Torremade Barreda and Dr. Navarro Vilches both completed fellowships at Memorial Sloan Kettering Cancer Center. Choosing a surgeon with this specific international oncology background ensures a higher standard of surgical precision even for routine stone procedures.</p> <p><strong>Patient Consensus:</strong> Experienced patients emphasize verifying the surgeon’s specific volume with digital flexible scopes rather than general surgery. They also recommend requesting a clear post-operative plan for stent removal and follow-up imaging.</p>"}],"h2":[{"text":"Qual é o Custo de Ureterorenoscopia flexível (URS) em Espanha? 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