RIRS kidney stone surgery A journey to the stone, without a single cut.
Follow a hair-thin flexible scope from the moment it enters the body to the moment a laser turns the stone to dust. Six stops, no incisions.
- UrethraNatural passage
- BladderEntry point
- UreterThe long climb
- KidneyThe stone
RIRS (Retrograde IntraRenal Surgery) treats kidney stones with a thin, flexible scope passed through the urethra, bladder and ureter into the kidney. The tip bends to reach every corner of the kidney, and a laser turns the stone to dust. There are no cuts or stitches, and most patients go home the same day or next morning.
How RIRS is performed, stop by stop.
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STOP 01
Step 1: Entering without an incision
After anaesthesia (general or spinal), the scope enters through the urethra, the same natural passage urine leaves by. There is no cut anywhere on the skin.
Preventive antibiotics are given, and a urine culture beforehand makes sure there is no infection.
0 incisions, stitches or drains -
STOP 02
Step 2: Up the ureter to the kidney
From the bladder, the scope climbs the ureter, the narrow tube that carries urine down from the kidney. A soft access sheath often lines the way, so the scope can pass in and out gently.
Live X-ray and a camera at the scope's tip guide every millimetre.
25–30 cm the typical length of an adult ureter -
STOP 03
Step 3: Exploring the kidney's calyces
The kidney isn't one hollow space. It drains through a branching system of cups called calyces, like the branches of a tree.
A straight instrument can't turn into these branches. The flexible scope's tip bends so it can look into each one.
Every calyx checked, top to bottom -
STOP 04
Step 4: Locating the kidney stone
Stones often settle in the lowest calyces, where gravity holds them. That is exactly where shock-wave fragments tend to stay behind, and where RIRS makes the biggest difference.
The stone's size, hardness and position decide the laser settings. See all kidney stone treatments
Lower pole the hardest spot for other methods -
STOP 05
Step 5: Laser lithotripsy turns the stone to dust
A fine laser fibre passes through the scope. Holmium or thulium laser energy breaks the stone into dust that washes out with urine. Larger pieces are collected in a tiny basket and sent for analysis.
All stone types including hard cystine and brushite -
STOP 06
Step 6: Placing a temporary JJ stent
The scope is withdrawn, and a thin, soft JJ stent is usually left inside the ureter. It keeps urine draining while any swelling settles, and is removed after 1–2 weeks.
The whole procedure usually takes 45–90 minutes. Most people go home the same day or the next morning.
45–90 min from start to finish
Is RIRS right for your kidney stone? Two quick questions.
Answer from your CT or ultrasound report to see which treatment is usually considered first.
Where is the stone?
How big is it?
RIRS
A kidney stone between 5 mm and 2 cm is the classic case for RIRS. The flexible scope reaches it wherever it sits, and the laser dusts it in a single sitting.
Also worth knowing: small, soft stones in easy positions can sometimes be treated with shock waves (ESWL) instead.
A guide only. Your treatment is decided after Dr. Utture reviews your scan and health history at Lilavati (Bandra), S.L. Raheja (Mahim) or Hinduja (Khar), Mumbai. Locations
RIRS vs ESWL, URS and PCNL: which is better?
Choose RIRS for lower-pole, hard, or previously failed stones. ESWL can suit small, soft stones and needs no scope, but may need repeat sessions.
Semi-rigid URS is ideal for stones lower down in the ureter. RIRS takes over where the path curves into the kidney.
PCNL uses a small keyhole in the back and clears large stones (over 2 cm) fastest. RIRS avoids any puncture, which matters for patients on blood thinners.
Figures are typical ranges and vary with stone size, position and hardness.
RIRS recovery time, week by week.
Swipe through the first weeks. The bar shows roughly how close to normal most people feel.
Procedure day
Awake within the hour, walking and drinking fluids within a few hours.
Home
Discharge the same evening or next morning, with oral medicines only.
Desk work
Back to office work and light activity. Keep fluids high to flush stone dust.
Stent out
A quick outpatient removal. Burning and frequency from the stent go away.
All clear
A scan confirms you're stone-free. Stone analysis shapes your diet and fluid plan.
Call the clinic straight away if you have fever, chills, severe pain, or cannot pass urine after the procedure.
RIRS surgery FAQs: cost, success rate & risks.
What does RIRS stand for?
RIRS stands for Retrograde IntraRenal Surgery. “Retrograde” means the scope travels upward through the natural urinary passage, from the urethra and bladder, up the ureter and into the kidney, so no cut is made in the skin.
How large a kidney stone can RIRS treat?
RIRS works best for kidney stones between about 5 mm and 2 cm. Selected larger stones can be treated in two sittings, or when keyhole surgery (PCNL) carries higher risk, but most stones over 2 cm are better treated with Mini-PCNL.
Is RIRS painful?
No. RIRS is done under general or spinal anaesthesia, so there is no pain during the procedure. Afterwards there may be mild discomfort from the temporary stent, which settles once it is removed after 1–2 weeks.
How long is recovery after RIRS?
Most patients go home the same day or the next morning and return to desk work within 3–5 days. Heavy lifting and strenuous exercise are avoided until the stent is removed.
Why is a stent needed after RIRS?
A JJ stent is a thin, soft tube placed inside the ureter to keep urine draining while swelling settles after surgery. It is removed as a short outpatient procedure after 1–2 weeks.
Is RIRS better than ESWL (shock wave treatment)?
For lower-pole stones, hard stones and stones that did not clear after ESWL, RIRS usually gives much higher stone-free rates. ESWL can still suit small, soft stones in easy positions. The choice depends on your CT scan.
Is RIRS the same as laser kidney stone surgery?
RIRS is one type of laser stone surgery. It uses a flexible scope to reach stones inside the kidney. Laser surgery for stones in the ureter usually uses a semi-rigid scope (URS). Both use the same holmium or thulium laser.
What is the success rate of RIRS?
For kidney stones up to 2 cm, RIRS clears the stone completely in about 85–95% of cases in a single sitting. Success depends on the stone's size, hardness and position. A follow-up scan after 4–6 weeks confirms the result.
How much does RIRS cost in Mumbai?
The cost of RIRS depends on the hospital, room category, stone size and number, the laser used, and whether a stent is placed. Most health insurance policies in India cover RIRS. Share your CT report with the clinic for a written estimate for Lilavati, S.L. Raheja or Hinduja Khar.
What are the risks and side effects of RIRS?
RIRS is very safe, but no procedure is risk-free. Common, temporary effects are blood in the urine, burning and urgency from the stent. Less common risks include urine infection or fever, and rarely injury to the ureter. Checking for infection beforehand and using an access sheath keep these risks low.
This article is for patient education and does not replace a medical consultation. Outcomes and recovery vary between individuals. Stone-free rates are typical ranges reported for these procedures.