Retrograde intrarenal surgery (RIRS) is a laser-driven endoscopic surgical method for kidneys. During RIRS, a flexible ureteroscope is inserted into the urine-collecting portion of the kidney through the urethra, bladder and ureter. The ureteroscope is pushed retrogradely through the urinary tract towards the intrarenal region where the stone is present. B/L RIRS is used to remove bilateral renal calculi without incising the kidneys.
RIRS is indicated for patients with kidney stones of 1.5cm in diameter. A fibre optic endoscope and a laser fibre named Holmium are used for eliminating kidney stones in B/L RIRS. Before the surgery, the patient undergoes a body check-up to determine their general health and fitness for the surgery. In some cases, a double J stent is inserted two weeks before the surgery to help with seepage. A urologist, also known as an endourologist, with adequate expertise performs the procedure.
The ureteroscope is pushed upwards through the urinary tract and placed in the kidney using the live X-ray method called fluoroscopy. In contrast, the patient is under sedation, and the renal stone is crushed, impacted by laser or taken out using forceps.
The patient is discharged from the hospital approximately after 24 hours of the surgery, and proper rest of at least one day is advised before resuming normal daily activities. However, the discharge from the hospital depends on the individual patient’s medical condition. Medicines are prescribed approximately for a week. After a week, a follow-up is scheduled to assess the patient’s condition and ensure that the body is clear of any stones.
It is generally a one day procedure, so one can expect to go home on the same day after the procedure. After surgery, most individuals can resume normal activities within 4-6 weeks.
Post-procedure care: Some blood may appear in their urine for 1-2 weeks which can be managed by the instructed medications and diet with fluids or liquids. Avoid strenuous activity until cleared by your doctor, and follow the doctor’s instructions for stent care.
In India, RIRS costs around one lakh fifteen thousand rupees only. Nevertheless, the total cost of the surgery might be more or less than that. It depends on numerous factors such as the hospital chosen, hospital location, rooms selected, insurance coverage, recuperation time, hospital stay length, etc.
| Description | Cost |
|---|---|
| Cost of RIRS in India | Around Rs. 1,15,000 |
| Cost of RIRS in Hyderabad | Rs. 90,000-1,10,000 |
| Description | Cost |
|---|---|
| Number of days in the hospital | Approximately one day |
| Type of surgery | Major |
| Anaesthesia type | Spinal or general or local anaesthesia |
| Recovery | Around two days |
| Duration of the procedure | One to two hours |
| Surgery | Minimally invasive |
No major complications are typically associated with B/L RIRS. Studies have indicated that RIRS is associated with lower complications than other stone-manipulation modalities like percutaneous nephrolithotomy (PCNL). Rarely observed risks and complications associated with B/L RIRS are:
Talk to Our Health Care Experts!
Stenting following RIRS is not always necessary, especially for patients without any complications. Inserting a stent is associated with an increase in treatment cost, operation time and risks related to mortality. However, stents are inserted after RIRS to prevent blockage of the ureter with post-operative oedema or blood clots and permit urine drainage.
Retrograde intrarenal operation (RIRS) is performed in order to treat complex kidney stones. It is the best alternative for patients who are not getting effective results through other procedures or who are unable to get treatment with other approaches.
Straining to defecate is warned following stenting as it might result in bleeding. Usually, bowel movements on alternate days are appropriate. If there is any difficulty associated with defecation, consult the healthcare professional.
RIRS is faster than traditional kidney-stone-removal procedures. It usually lasts around one to two hours, whereas Percutaneous Nephrolithotomy(PCNL) lasts for approximately three to four hours. Moreover, its recovery time is also shorter than that of other traditional procedures.
Compared with PCNL, RIRS is better on the basis of factors such as hospital stay, analgesic use, pain, decrease in haemoglobin and fluoroscopy time. RIRS is a non-invasive method, whereas PCNL is invasive. Thus, recovery is faster in RIRS than in PCNL.
RIRS is considered the safest modality in kidney-stone manipulation as it has fewer complications when compared with PCNL. In addition, RIRS can be performed in patients with bleeding diathesis, ectopic kidneys or chronic renal failure.
RIRS is an effective procedure for treating various kinds of stones. RIRS offers several benefits over traditional or open approaches, such as its minimally invasive nature, shorter hospitalization, quick recovery, and ability to treat complex stones.
Generally, following RIRS, high pain is not reported. In particular, compared with other renal stone manipulation modalities, RIRS is associated with no pain, and its recovery time is also minimal. The average pain score of RIRS is 2.38/10 according to the numerical rating scale in a prior study.
Appointment
Second Opinion
WhatsApp
Call
More
