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RIRS — Retrograde Intrarenal Surgery

Flexible Ureteroscopic Laser Lithotripsy

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Üroloji department. Book Appointment →

What is RIRS — Retrograde Intrarenal Surgery?

Flexible ureteroscope advanced retrograde through the urethra to the renal pelvis.

Holmium:YAG or thulium fiber laser fragments stones via dusting or fragmentation technique.

Stone-free rate approaches 80-90% for renal stones <20 mm in a single session.

Can be combined with pre-stenting to facilitate ureteral access and reduce sepsis risk.

Symptoms

Renal stones <2 cm not amenable to or failed by SWL
Lower-pole stones with favorable infundibulopelvic angle
Patients on anticoagulation — lower bleeding than PCNL
Obese patients where SWL is unfavorable
Residual fragments after PCNL (ancillary use)
Anatomic anomalies (horseshoe kidney, ectopic kidney) where PCNL is difficult

Risk Factors

Ureteral injury, perforation, or avulsion
Post-operative urosepsis — strongest in untreated UTI
Ureteral stricture formation
Need for pre-stenting or two-stage procedure in tight ureters
Stone migration or retropulsion
Incomplete clearance requiring repeat RIRS or conversion to PCNL

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Fever with chills after RIRS (sepsis)
  • Severe flank pain with hydronephrosis or stent discomfort
  • Persistent hematuria beyond 1 week or new obstruction symptoms

Treatment Methods

01
Preoperative urine culture treatment and pre-stenting in selected cases
02
Flexible ureteroscopy using single-use or reusable scopes with ureteral access sheath
03
Holmium or thulium fiber laser dusting/fragmentation per stone composition
04
Basket extraction of larger fragments; intrarenal pressure monitoring if available
05
Postoperative double-J stent for 5-14 days
06
Stone analysis, metabolic workup, and tailored prophylaxis at follow-up

Which Department to Visit?

You can visit our Üroloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Üroloji Department

Let us help you

You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.