Surgical removal of stones impacted in the submucosa of the distal ureter is difficult. A local-prototype visual urethrotome was evaluated for the management of submucosal vesicoureteral stones and as an aid in the removal of a Dormia basket with an entrapped stone impacted in the submucosa of the vesical portion of the ureter. A total of 14 male and 11 female adult patients were included. Fifteen patients required ureteral meatotomy to release the stone. Transurethral ureteral meatotomy is a precise and safe procedure associated with minimal complications when carefully done. Our local-prototype instrument proved to be a simple, economical, and valuable tool.