Retrograde intrarenal surgery, or RIRS, is an endoscopic procedure used to treat selected kidney stones. A flexible telescope passes through the urinary passage to reach the kidney, where a laser can break stones into smaller fragments.
Potential benefits include avoiding a skin incision and treating stones under direct vision. However, RIRS still involves anaesthesia, instruments within the urinary tract and possible complications. Complete clearance in one procedure cannot be guaranteed.
RIRS is a form of flexible ureteroscopy. The instrument travels through the urethra into the bladder, then up the ureter to the kidney’s collecting system.
A laser fibre passed through the telescope fragments the stone. Some fragments may be retrieved using a small basket; others may be left sufficiently small to pass naturally.
A temporary ureteric stent may be inserted to support drainage afterwards.
RIRS reaches the kidney through the urinary tract, avoiding an incision through the skin. This does not mean it is non-invasive: instruments enter the body, and internal injury remains possible.
The flexible telescope allows the surgeon to see inside the kidney’s collecting system and direct treatment towards accessible stones.
Some patients can return home on the day of treatment or following an overnight stay. Discharge depends on recovery from anaesthesia, symptoms and any complications.
These benefits should be considered alongside the likelihood of residual stones, stent symptoms and additional procedures.
No. Treatment selection depends on:
For renal stones larger than 2 cm, percutaneous nephrolithotomy, or PCNL, is generally the preferred first-line procedure. RIRS may be considered in selected circumstances, with a greater likelihood of staged treatment.
Some stones can be monitored. Read more about kidney and ureteric stones.
Possible complications include:
A tight ureter may require temporary stenting before another attempt. These possibilities should form part of the consent discussion.
Assessment may include review of imaging, kidney function, urine testing, medicines, allergies and fitness for anaesthesia.
Tell the team about prescribed medicines, supplements and previous anaesthetic problems. Follow individual fasting and medicine instructions; do not independently stop blood thinners or other prescribed treatment.
An infected, obstructed kidney requires urgent care. Drainage and infection treatment may be needed before definitive stone removal.
A stent is a temporary internal tube between the kidney and bladder. It may help drainage following treatment.
Stents can cause urinary frequency, urgency, blood in urine or discomfort. Before discharge, confirm whether a stent was placed and when and how it will be removed or exchanged.
Recovery varies. Mild burning, urinary discomfort and blood in urine can occur initially.
Follow the discharge instructions for medicines, fluids, activity and follow-up. Return to work, exercise and driving should reflect symptoms, anaesthetic recovery and the treating team’s advice.
Seek urgent medical assessment for fever or chills, severe or worsening pain, inability to pass urine, or heavy bleeding.
Yes. Treating an existing stone does not remove every underlying cause of stone formation.
Prevention may involve stone analysis, appropriate fluid intake and dietary changes tailored to the stone type. Advice about sodium, animal protein, calcium or oxalate should reflect individual findings rather than a universal restrictive diet.
Further procedural information is available on the RIRS information page.
It allows selected kidney stones to be treated through the urinary tract without a skin incision. Suitability requires individual assessment.
No. Instruments enter the urinary tract, and anaesthetic and procedural risks apply.
Anaesthesia is used during treatment, but discomfort can occur afterwards, particularly with a stent.
Not always. Residual stones or difficult access may require another procedure.
No. The decision depends on the procedure and clinical findings.
Timing varies with recovery, symptoms, medicines and activity demands. Follow the treating team’s instructions.
No. Prevention and follow-up remain important after treatment.
RIRS is one option for treating kidney stones. Avoiding a skin incision and accessing stones under direct vision are potential benefits, but these must be balanced against complications, stent symptoms and possible repeat treatment. Decisions should follow an individual discussion of the available options.
This article provides general educational information and does not replace individual medical assessment.
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