RIRS

What are Kidney Stones?

Kidney Stones are also known as Nephrolithiasis or Renal Calculi. These hard deposits form inside one or both the kidneys and vary in size and number.

Kidney Stones form when an imbalance occurs in the various chemicals that are present in the urine. The most commonly involved chemicals are calcium, oxalate, citric acid, uric acid and cysteine.

What causes Kidney Stones?

WHAT IS RIRS ?

Retrograde Intrarenal Surgery (RIRS): This is a medical procedure used in urology for the treatment of kidney stones. It involves passing a small fiberoptic instrument called a ureteroscope through the urethra and bladder, up into the ureter, and then into the kidney. This allows the surgeon to visualize and access the kidney stones to break them up or remove them.

Advantages of RIRS

Minimally invasive

A straightforward and faster method

Shorter recovery time

Less painful

Less morbidity

Insignificant bleeding

No danger to the renal tissue

Less inconveniences

Risks of Delayed RIRS Treatment

Increased pain and discomfort

Progression of the condition

Recurrent Urinary Tract Infections

Blockage in Urinary Bladder

Permanent Damage to Kidneys

Formation of new stones

What To Expect?

Before a RIRS surgery?

During a RIRS surgery?

After a RIRS surgery?

A retrograde intrarenal operation (RIRS) is a simple, less invasive, and less likely to cause problems. Before Surgery, patient need to undergo these tests.

Blood test
X-ray KUB (Kidney, Ureter, Bladder)
Pre-operative fitness from anaesthetist

In a few situations, pre-operative DJ stenting is required two weeks before the procedure; this stenting allows the ureteroscope to enter the kidneys more easily because the ureter is already dilated. Patients are kept 6–8 hours on an empty stomach before surgery.

The patient will be sedated with anaesthesia, and the urologist will use a digital or fibre optic endoscope – a thin, flexible tube – to reach the bladder through the urethra and then to the kidney’s urine storage area. The endoscope will detect stones and blast them with a laser until golden sand forms.

Furthermore, the DJ stent is to be placed for 1 to 2 weeks before or after the RIRS surgery, aids the smoothing and speeding of recuperation; in most cases, patients are discharged the next day following surgery.

A urologist inserts a urinary catheter into the urethra to relieve pain and difficulty peeing; the catheter is left in place for 8 to 24 hours. After that, the patient will be shifted to the recovery room for monitoring for 6 to 8 hrs after the surgery. The patient will be taken to a hospital room to rest for at least 24 hours.

Furthermore, the patient must drink a large amount of fluids each day, at least 3 litres, in order to avoid infection and maintain urine output. In addition, if the patient is in good health and is able to resume normal activities the next day after surgery, he or she may be discharged. However, a follow-up with the primary care doctor is important.

Frequently Asked Questions

What happens during the RIRS procedure?

During the RIRS (Retrograde Intrarenal Surgery) procedure, the patient is usually given general anaesthesia, although in some cases, local anaesthesia with sedation may be used. Here are the general steps involved in the RIRS procedure: A cystoscope is inserted into the bladder through the urethra, allowing the urologist to view the inside of the bladder and ureter. A small guide wire is inserted through the cystoscope and advanced into the kidney. A flexible ureteroscope, a thin and long tube with a camera and a laser or other instruments on its tip, is passed over the guide wire and into the kidney. The urologist will then use the instruments to locate the kidney stone or other abnormal tissue and remove it or break it into smaller pieces that can be quickly passed out of the body in urine. After the procedure, a stent (a small, soft tube) may be placed in the ureter to help heal and promote urine flow.

How long does the RIRS procedure take?

The duration of the RIRS (Retrograde Intrarenal Surgery) procedure can vary depending on several factors, including the size and location of the kidney stone or other abnormal tissue being treated, the patient's anatomy, and the complexity of the procedure. In general, the RIRS procedure can take anywhere from 45 to 60 minutes.

Is the RIRS procedure painful?

Most patients do not experience significant pain during the RIRS (Retrograde Intrarenal Surgery) procedure itself because they are given anaesthesia to numb the area and put to sleep with general anaesthesia. However, after the procedure, some patients may experience mild to moderate discomfort, such as pain or soreness in the lower back or abdomen and burning during urination. These symptoms usually improve within a few days and can be managed with over-the-counter pain relievers, as your urologist recommends.

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