RIRS Surgery in Indore: Laser Kidney Stone Treatment Without Cuts

Consult Dr. Vikas Singh, MCh Urology, at Vishesh Jupiter Hospital, Indore

Retrograde intrarenal surgery (RIRS) removes kidney stones through the natural urinary passage using a thin, flexible telescope and a laser. There is no incision, no cut on the skin and no stitches. Most patients go home within a day.

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What is RIRS?

RIRS stands for retrograde intrarenal surgery. A very thin flexible scope (flexible ureteroscope) is passed through the urethra, bladder and ureter up to the kidney. The surgeon sees the stone on a screen, breaks it into small pieces with a laser (holmium or thulium fibre laser) and removes the fragments or lets the finest dust pass naturally.

Because the kidney is reached from inside, there is no puncture of the kidney and much less risk of bleeding than with open or percutaneous surgery.

Who is RIRS suitable for?

RIRS is commonly advised for:

Kidney stones up to about 2 cm, including stones in the lower part of the kidney
Stones that did not break with ESWL (shock wave lithotripsy)
Residual stone fragments after PCNL
Patients on blood thinners or with bleeding tendency, where a kidney puncture is risky
Patients with obesity, spine or skeletal deformity, or an unusually placed kidney
Multiple stones in the same kidney, or stones in both kidneys in selected cases

Larger stones (about 2 to 3.5 cm) can also be treated with RIRS in experienced hands, sometimes in two stages. Very large or hard stones, or stones in a kidney with a blocked outlet, may be better treated by PCNL. The right choice depends on your CT scan, so the decision is made after examining your reports.

RIRS vs PCNL vs ESWL vs URS

[Dr. Singh: please check this table against your own practice.]

Before surgery: what to expect

Consultation and imaging. A non-contrast CT scan (CT KUB) shows the size, number, position and density of the stones.
Urine culture. If the urine has infection, it is treated with antibiotics first. Operating on an infected system can cause serious infection, so surgery is postponed until the urine is clear.
Blood tests and anaesthesia check. Blood thinners and some other medicines may need to be adjusted. Please tell us about every medicine you take.
Sometimes a stent first. In some cases, a DJ stent is placed a few weeks earlier to widen the ureter and make the main surgery safer.

The RIRS procedure, step by step

You are given anaesthesia, and the surgery takes about 45 to 90 minutes depending on the stone burden.
The flexible scope is passed up to the kidney, and the stone is located.
The laser breaks the stone into small fragments. Larger pieces are removed with a tiny basket.
A DJ stent (a thin soft tube between kidney and bladder) is usually left in to keep the ureter open and let the kidney drain while it heals.
You are shifted to the room and can usually walk within hours.

Recovery after RIRS

Hospital stay: usually one night, sometimes day care
Back to desk work: commonly within 2 to 4 days
DJ stent: usually removed after 1 to 3 weeks in a short procedure. Stent symptoms are common while it is in place: burning, urgency, blood in urine and mild flank discomfort. These settle after removal. Our page on the [DJ Stent Complete Info] explains this in detail.
Drink plenty of water, about 2.5 to 3 litres a day unless you have been told to restrict fluids
Follow-up: an ultrasound or CT scan is advised after surgery to confirm that no fragments remain

Possible risks and complications

RIRS is a safe, widely used procedure, but no surgery is risk-free. Your surgeon will explain these before you consent:

Stent-related discomfort and blood in urine (common, temporary)
Urine infection or fever; rarely, serious infection (sepsis)
Residual fragments, which may need a second procedure or later treatment
Injury to the ureter, which is uncommon and which can rarely lead to narrowing (stricture)
Anaesthesia-related risks
A staged procedure being needed if the ureter is too narrow for the scope

Success rates depend on stone size, position and hardness and on your anatomy. [Dr. Singh: add your own stone-free rate and complication numbers here only if audited.]

Cost of RIRS in Indore

The cost depends on:

Size and number of stones
Type of laser and disposable scope used
Hospital room category and length of stay
Whether a stent is placed first, and any second-stage procedure
Insurance and TPA coverage

[Dr. Singh: state a range here if you are comfortable, or write "Please contact our team on WhatsApp for an estimate based on your reports."] Most health insurance policies cover RIRS when it is medically advised. [Confirm with the hospital's TPA desk.]

Preventing stones from coming back

Kidney stones recur in many patients. After RIRS, we advise:

Fluids to keep urine pale and above 2 to 2.5 litres a day
Less salt, and normal (not low) dietary calcium
Moderate animal protein, and fewer high-oxalate foods if your stone is of that type
A stone analysis and, where needed, blood and urine tests (24-hour urine) to find the cause

Your diet plan depends on your stone type, so please do not start restrictive diets without advice.

About the surgeon

Dr. Vikas Singh, MCh (Urology), is a urologist, uro-oncologist and kidney transplant surgeon in Indore. [Add medical registration number and council, e.g. MP Medical Council Reg. No. ____.] His practice includes laser stone surgery (RIRS, URS, PCNL), prostate surgery (HoLEP, UroLift, iTind), robotic and laparoscopic surgery, and kidney transplantation. [Add numbers of RIRS procedures performed only if exact and verifiable.]

Medically reviewed by Dr. Vikas Singh. Last updated: [month, year].

Where to consult

Vishesh Jupiter Hospital Scheme No 94, Ring Road, near Teen Imli Chauraha, Sector 1, Radha Swami Nagar, Indore, Madhya Pradesh 452001

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[Add OPD days and timings.]

10. Frequently asked questions

Is RIRS painful?

The surgery is done under anaesthesia, so you feel nothing during it. Afterwards, mild discomfort and urinary burning from the stent are common and can be eased with medicines.

How long does RIRS take?

Usually 45 to 90 minutes. Larger stones or multiple stones can take longer.

Is RIRS better than PCNL? Neither is better for everyone. RIRS avoids a puncture in the kidney and suits stones up to about 2 cm. PCNL is usually preferred for larger stones. Your CT scan decides the choice.

Will I need a DJ stent?

Most patients have a stent for 1 to 3 weeks after RIRS. It is removed in a short procedure.

Can all the stone be removed in one sitting? For small and moderate stones, usually yes. For larger or very hard stones, a second sitting may be needed, and we will tell you this in advance.

When can I go back to work?

Most people return to light work in 2 to 4 days. Avoid heavy lifting and strenuous exercise until your doctor allows it, and until the stent is out if it causes symptoms.

Can stones come back after RIRS?

Yes. RIRS removes the stones but does not change the cause. Fluids, diet changes and, where needed, a metabolic check lower the risk.

Is RIRS safe in a patient on blood thinners?

RIRS carries a lower bleeding risk than PCNL, which is why it is often chosen for these patients. Blood thinners should only be stopped or adjusted under your doctor's guidance.

Does insurance cover RIRS?

Most policies cover it when medically indicated. Please share your policy details with our team for pre-authorisation.

When should I see a doctor urgently?

Go to an emergency department if you have severe flank pain with fever or chills, cannot pass urine, are vomiting continuously, or see heavy bleeding. Fever after surgery needs same-day attention.

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