Mail Id.
drdhrutimahajan@gmail.com
Phone No.
+91 89288 45185
RIRS (Retrograde Intrarenal Surgery)
Retrograde Intrarenal Surgery (RIRS) is a modern, minimally invasive laser procedure used to treat kidney and upper ureteric stones. A thin, flexible ureteroscope is passed through the urinary tract to access the kidney. Using laser energy, stones are fragmented into fine particles, which are either removed or passed naturally through urine.
RIRS avoids external cuts, reduces pain, and offers high stone clearance rates, making it a preferred option for patients with complex, hard, or multiple stones.
Indications for RIRS
- Kidney stones located in hard-to-reach areas.
- Stones resistant to shockwave therapy (ESWL).
- Multiple or large stones requiring precise laser fragmentation.
- Patients unfit for open or percutaneous surgery.
How the Procedure is Performed
Pre-Procedure Preparation
- Fasting for 6–8 hours before surgery.
- Avoid aspirin or blood thinners for at least 7 days prior (as advised by doctor).
- Routine imaging (Ultrasound, CT scan, or X-ray) to assess stone size, hardness, and location.
- In selected cases, DJ stenting may be placed 1–2 weeks earlier to ease scope entry and recovery.
During the Procedure
- Performed under general or spinal anesthesia.
- A flexible ureteroscope is guided through the urethra and bladder into the kidney.
- Laser energy (Holmium: YAG / Thulium) fragments the stone into tiny particles.
- Fragments are either flushed out or left to pass naturally with urine.
- A temporary stent may be placed to improve drainage and reduce swelling.
Post-Procedure Care
- Most patients are discharged within 24 hours.
- A mild burning sensation, blood-tinged urine, or flank discomfort may persist for a few days.
- Painkillers and antibiotics are prescribed to aid recovery.
- Stent removal is usually scheduled after 1–2 weeks.
Benefits of RIRS
- Minimally invasive with no external incisions.
- Safe and effective even for hard or multiple stones.
- High stone clearance rates (up to 95–98%).
- Reduced blood loss and faster recovery compared to open surgery.
- Suitable for patients on blood thinners or with cardiac conditions.
- Short hospital stay and early return to routine life.
Possible Risks & Complications
- Urinary tract infection.
- Minor bleeding from the kidney.
- Failure to access the stone in some cases.
- Stone fragments not completely cleared, requiring repeat treatment.
- Temporary discomfort due to stent placement.
Aftercare & Prevention
Most patients resume light activities within 2–3 days. Long-term prevention focuses on:
- Drinking 2–3 liters of water daily to keep urine clear.
- Reducing salt, excess protein, and oxalate-rich foods in the diet.
- Managing conditions like diabetes, obesity, or gout that increase stone risk.
- Regular follow-up with imaging to ensure no residual stones.