Inclusion Criteria:  Participants with renal or ureteral urinary stones who require endoscopic treatment in the outpatient operating room Participant's stone size in a single renal unit of 3-10 mm and 11-20 mm. Stone size is defined as the largest diameter of a single stone on pre-operative CT. Participants with multiple stones will be included as long as their largest stone size falls within the above parameters.  Exclusion Criteria:  Participants under 18 years of age and over 89 years old. Pregnant participants Participants with transplant kidneys Participants with irreversible coagulopathy Participants with known ureteral stricture disease Participants who do not have a pre-operative CT. Non-English speaking, vulnerable participants such as lacking of decision-making capability, prisoner, adult unable to consent, will not be enrolled.