Retrograde Intrarenal Surgery (RIRS)

Retrograde Intrarenal Surgery (RIRS) is a minimally invasive procedure used to treat kidney stones and certain other kidney conditions. It involves inserting a thin, flexible tube called a ureteroscope through the urinary tract to access the kidney. A laser is then used to break the kidney stones into small fragments, which can either be removed or pass naturally through the urinary tract. 

RIRS is recommended for patients who:

• Have kidney stones that are difficult to treat with non-invasive methods.
• Have anatomical abnormalities that make other treatments difficult.
• Have failed to respond to other treatments for kidney stones.
• Are in good general health. 

Anesthesia: You will be placed under general anesthesia to ensure comfort during the procedure.

Ureteroscope Insertion: A flexible ureteroscope is inserted through the urethra, bladder, and ureter to reach the kidney

Stone Visualization and Fragmentation: Using a high-resolution camera, the surgeon locates the kidney stones. A laser is then used to break the stones into smaller pieces.

Stone Removal: The fragmented stones are either removed using specialized tools or allowed to pass naturally through urine

Stent Placement: A temporary stent may be placed in the ureter to ensure proper drainage and aid recovery. 

• Medical Evaluation: Your doctor will assess your medical history, overall health, and details about your kidney stones.
• Imaging Tests: Tests like CT scans or ultrasounds may be conducted to locate the stones accurately.
• Fasting: You may be instructed to fast for 6-8 hours before the procedure.
• Medication Review: Inform your doctor about all medications you are taking, including over-the-counter drugs and supplements.

• Hospital Stay: Most patients are discharged the same day or the next day after the procedure.
• Discomfort: You may experience mild burning or bleeding during urination for a short time.  
• Stent Management: If a stent is placed, it is usually temporary and will be removed in a follow-up appointment.
• Activity: Rest is advised for a few days, and strenuous activities should be avoided.
• Hydration: Drink plenty of fluids to help flush out any remaining stone fragments.

While RIRS is generally safe, potential risks include:

• Infection: May require antibiotic treatment.
• Bleeding: Minor bleeding during or after the procedure.
• Injury: Possible injury to the ureter or kidney.
• Incomplete Stone Removal: May necessitate additional procedures. Your doctor will discuss these risks with you and take precautions to minimize them.
• Staged procedure: In case of tight ureter, the doctor may place only the stent in first sitting. This is done, to avoid instrumental damage to the ureter. Stent helps to widen the urinary passage. Stone and stent are removed later on, usually after 2- 4 weeks.

Seek medical attention if you experience:

• Fever or chills
• Severe pain not relieved by prescribed medications
• Persistent nausea or vomiting
• Heavy bleeding during urination

• Stent Removal: If a stent was placed, a follow-up appointment will be scheduled for its removal.
• Imaging Tests: Post-procedure imaging may be conducted in some patients, to ensure all stones have been cleared.
• Lifestyle Recommendations: Your doctor may provide dietary and lifestyle advice to prevent future kidney stones.