High Powered Stone Dusting vs. Fragmentation and Basketing at Time of Ureteroscopy

This study compares two techniques used during ureteroscopy — a procedure to remove kidney stones using a small camera inserted through the urinary tract. The two approaches being compared are: (1) high-powered laser dusting, which turns stones into fine powder, and (2) fragmentation and basketing, which breaks stones into pieces and removes them. The goal is to determine which method is safer and more effective for larger stones located in the upper urinary tract. You may be eligible if: - You are 18 to 89 years old - You are scheduled for ureteroscopy to remove kidney stones - Your stone is 6mm or larger and located in the mid-ureter or higher (closer to the kidney) - You are willing to sign an informed consent form - You can read and complete questionnaires, including pain assessments - You have a phone capable of receiving text messages You may NOT be eligible if: - You are under 18 years old - You are unable to provide informed consent - You are also having a simultaneous procedure (e.g., percutaneous nephrolithotomy or laser prostate surgery) - You have only one kidney - You have nephrocalcinosis (calcium deposits throughout the kidneys) - You are considered a vulnerable patient population member Talk to your doctor to see if this trial is right for you.