RIRS (Retrograde Intrarenal Surgery)

Published with the inputs from Dr Bichu Joseph Maliakal, Associate Consultant,  Urology, Baby Memorial Hospitals- Kozhikode

Retrograde Intrarenal Surgery (RIRS) is a minimally invasive procedure used to treat kidney stones and certain kidney conditions. It involves passing a flexible ureterorenoscope through the urinary tract (without any cuts on the body) to access the kidney. Using a laser, stones are broken into fine dust and removed, allowing safe and scarless treatment.

What is RIRS?

RIRS is a endoscopic, scarless surgery where a flexible ureterorenoscope is passed via the urethra bladder and ureter into the kidney. A laser is then used to fragment and dust kidney stones. 

When is RIRS recommended?

RIRS is advised for patients with:

• Kidney stones less than 2 cm or larger stones in certain  circumstances
• Multiple stones in different locations of the kidney
• Stones in difficult-to-reach locations of the kidney
• Recurrent stones requiring minimally invasive treatment
• Patients unfit for  percutaneous (PCNL) surgery 

Is RIRS safe?

Yes. RIRS is safe and highly effective when performed by expert urologists. Risks like kidney infection, bleeding, or ureteral injury are rare and manageable.

What is the recovery like after RIRS?

• Most patients go home after surgery
• Minimal pain compared to other surgeries
• Return to routine activities in 1-2 days after discharge
• Ureteric Stent may be placed temporarily to keep the ureteric wide open and help the stone fragments and stone dust pass out with the urine

What size stones can RIRS treat?

RIRS can treat stones up to 2 cm effectively. For larger stones, PCNL may be recommended, but RIRS remains an option in selected cases, but one may need more than one sitting

How does RIRS compare to other kidney stone treatments?

• RIRS: Minimally invasive, scarless, faster recovery
• PCNL: Recommended for very large stones; more invasive
• Medical Dissolution Therapy: For smaller  radiolucent stone.
• ESWL:  Uses shockwaves, but not effective for all stones, was commonly used earlier, but now ESWL is out of vogue.                             Choice depends on stone size, location, and patient profile.

Can kidney stones come back after RIRS?

Yes, kidney stones can recur due to metabolic or dietary factors. Preventive steps include hydration, dietary modifications, and regular follow-ups with a urologist.

Connect with Our Experts Today

If you are suffering from kidney stones or recurrent urinary problems, the Urology Team at Baby Memorial Hospital (BMH) provides advanced RIRS (Retrograde Intrarenal Surgery) with safe, scarless treatment, quick recovery, and expert long-term care.

👉 Book an Appointment Online or visit BMH to consult our urology specialists.