RIRS (Flexible URS) Surgery for Kidney Stones

Kidney Stone Treatment with Flexible Ureteroscopy (URS) Flexible Ureteroscopy is a very popular and increasingly common treatment option for the treatment of kidney stones. Endoscopically, thin optical devices with cameras reach the kidney through the urinary tract and break the stone with a laser. The stone is usually pulverized and allowed to fall out on its own.

Another treatment alternative for kidney stones is shock wave therapy (ESWL). However, since anesthesia is not applied in shock wave therapy, it can be a painful treatment. In addition, some types of hard stones cannot be broken by ESWL treatment or break into large pieces and cannot fall out on their own. In such cases, Flexible URS treatment will again be required.

Flexible URS is used as an effective treatment method for all sizes of kidney stones thanks to increasing surgical experience and advances in technological developments.

Flexible Ureteroscopy Procedure and Aftermath The operation is typically performed under GENERAL ANESTHESIA but can also be performed under SPINAL ANESTHESIA in appropriate patients. Preoperative antibiotics are usually given to prevent possible infection. The procedure can take as little as 20 minutes for small stones and an hour or more for larger stones. There are no restrictions on the patient's physical activities after discharge.

During the operation, if the URS instrument does not pass through the renal canal (ureter) or if infection is detected, the procedure is usually postponed for 1 week by inserting a temporary catheter (double J stent) into the kidney to avoid harming the patient. During this period, the patient is given antibiotics and the operation 1 week later can be performed much more safely. If the stone has damaged the renal canal, a temporary catheter can be inserted after the operation to ensure proper healing, or if the stone remains in the form of stone crumbs without turning into powder, the patient can have a temporary catheter inserted after the operation to remove the crumbs without blocking the renal canal. Catheters are generally well tolerated and are removed on an outpatient basis with LOCAL ANESTHESIA.

What are the Side Effects of Flexible Ureteroscopy?

As with any surgical procedure, complications can occur, although rare. These complications include failure to remove stones, urinary infection and ureteral stricture. Serious complications, including bleeding, are very rare. Most side effects can be prevented by placing a catheter in the kidney.

What is RIRS?

RIRS for kidney stones is similar in many respects to URS treatment for kidney duct (ureter) stones. It involves pulverizing the kidney stones with a laser through the urinary canal. This treatment method is suitable for kidney stones of almost any size. The operation is performed by accessing the kidney with the help of optical devices with very thin cameras without making any incisions. After reaching the chambers of the kidney through the urinary canal, the stones are completely broken with the laser and crumbled and pulverized enough to be excreted in the urine.

Recovery Time After RIRS Since the operation is performed using the natural cavities of the kidney, patients can return to their normal lives the day after the operation.

Prof. Dr. Tarık Yonguç

Urology

Publication Date: 23.06.2025