Retrograde Intrarenal Surgery (RIRS)
RIRS Kidney Stone Treatment
RIRS is the newest method used in the treatment of kidney stones. Kidney stone disease is quite common in our society. Individuals often apply to the urology clinic, suspecting conditions such as flank pain and burning in urination. As a result of physical examination and USG, it is determined whether there are stones in the kidney. In addition, the size and position of the stone are monitored. Although there are many different methods in the treatment of kidney stones, PCNL closed kidney stone surgery and open surgery were the only options for large stones (more than 2 cm) before RIRS. As it is known, in PCNL, a small hole is opened in the patient’s body and the kidneys are reached and the stone is intervened. However, with the RIRS, it became possible to intervene in kidney stones up to 3.5 cm in diameter without drilling a hole in the patient’s body.
What is RIRS Kidney Stone Treatment?
RIRS is performed in the operating room and under general anesthesia. It is entered through the urinary tract with a very thin ureteroscope that can be bent and the stone in the kidney is reached. The stone is broken and taken out of the body in small pieces. The remaining small debris is excreted with the urine. Unlike PCNL, the most important advantage of this method is to perform the procedure without piercing a hole in the body.
Which Stones Are RIRS Applied To?
For small, medium and large stones up to 3.5 cm
Patients with more than one stone
Patients with stones in both kidney and ureter
Stones for which ESWL application does not give results
Patients with stones in both kidneys
Advantages over Other Kidney Stone Treatments
The most important advantage compared to PCNL is that there is no need to drill any holes in the body. This is an important advantage. It shortens the length of resting period, reduces the risk of infection and bleeding.
It is possible to be discharged 24 hours after the procedure. This period can be up to 3 days in PCNL.
The most important advantage compared to ESWL is that it can be applied to larger stones. ESWL can be applied to stones smaller than 2 cm. Today, we can apply the RIRS method to stones up to 3.5 cm.
All stones broken in ESWL are expected to be poured out through urine. This brings the risk of entrapment of some pieces in the urinary tract, depending on the size of the treated stone. However, during the RIRS procedure, large stones are removed from the body. Small spills should be excreted in the urine.
It can be applied to patients using blood thinners.
This method is primarily used in patients with congenital kidney anomalies.
Would Another Surgery Be Required?
When applied to the right patients, treatment takes place in a single session. The patient gets rid of the stones in their kidney. However, when applied to large stones, the stone may not be sufficiently broken and re-operation may be required. The largest kidney stone treated with RIRS in the literature is 3.5 cm in size. On the other hand, it is not a case that it can be applied to all patients with stones up to 3.5 cm. Surgeon’s experience, patient history, stone hardness and location are important components.