Procedure guide · Urology
Kidney stones that do not pass on their own can be removed through a scope passed up the urinary tract or through a small opening in the back. RIRS describes the first approach, a form of ureteroscopy. PCNL describes the second. MedlinePlus explains that percutaneous surgery is used for stones too large to pass or to treat through the bladder. A urologist chooses the approach.
What are RIRS and PCNL?
RIRS stands for retrograde intrarenal surgery. It uses a ureteroscope, which MedlinePlus describes as a thin tube with a light and camera. The scope passes through the urethra and bladder into the ureter and up towards the kidney. Stones can be removed with small instruments or broken up with a laser. MedlinePlus says ureteroscopy is done under general anaesthesia. A stent, a thin tube that lets urine and fragments pass, may be left in place and removed later.
PCNL stands for percutaneous nephrolithotomy. MedlinePlus explains that an instrument is passed through a small incision in the back into the kidney to remove the stone or break it up, under general anaesthesia. A tube may be left in the kidney and a stent in the ureter while it heals. The surgeon removes them once X-rays show the stones are gone and the kidney has healed.
Who may be suitable for each approach?
MedlinePlus says most kidney stones pass on their own. Treatment is considered when a stone blocks urine flow, causes severe pain despite treatment, causes infection or damages the kidney. MedlinePlus lists stones too large to pass or to treat through the bladder as a reason for percutaneous surgery. The urologist decides based on the stone’s size, position and hardness, your anatomy and your general health. Shock wave lithotripsy is another option for some stones.
Fever with a stone is urgent
MedlinePlus lists fever and chills, severe pain that will not ease and vomiting among warning signs. A blocked and infected kidney needs prompt local treatment. Do not delay care to travel.
What reports does a urologist ask for?
- A recent CT scan of the kidneys, ureters and bladder, with image files
- Ultrasound or X-ray reports if those are what you have
- Kidney function tests and a urine test, including any culture result
- Details of earlier stone treatment, stents or drains
- Stone analysis results if a previous stone was tested
- Medicines, especially blood thinners, and conditions such as diabetes or heart disease
How should you plan the trip?
- Consultation and repeat imaging or tests as needed
- Surgery under general anaesthesia
- Hospital recovery, with the team deciding on discharge
- Stent or drain plan: ask when and where it will be removed
- Before flying: ask your urologist when it is safe for you to fly
- Home: stone prevention advice and follow-up imaging with your own doctor
The stent question matters most for travellers. MedlinePlus notes that a ureteroscopy stent must be removed after a set period. That can be done at the hospital in India before you leave, or by a urologist at home. Agree this in advance. MedlinePlus also notes that most people need lifestyle or diet changes to help prevent new stones.
What should you ask the urologist?
- Do you recommend RIRS, PCNL or another approach for my stone, and why?
- Will I have a stent or a kidney drain, and who will remove it?
- What happens if fragments remain after the first procedure?
- Will you analyse the stone and send me the result?
- What prevention advice do you give for my type of stone?
- When will it be safe for me to fly home?
IndiaMedica helps you share scans and compare written plans. The treating urologist decides what is suitable.
Questions people ask
What is the difference between RIRS and PCNL?
RIRS reaches the stone with a scope passed up through the urethra and bladder, with no cut in the skin. PCNL reaches the kidney through a small incision in the back. MedlinePlus explains that percutaneous surgery is used for stones too large to treat through the bladder. Your urologist chooses the approach.
What are the risks of stone surgery?
For ureteroscopy MedlinePlus lists injury to the ureter or kidney, infection and narrowing of the ureter, plus general surgical risks. For percutaneous procedures it lists bleeding around the kidney, infection, fragments left behind and reduced kidney function. Ask your surgeon to explain your own risks.
Will I need a stent after kidney stone surgery?
Often yes. MedlinePlus describes stents placed after ureteroscopy and after percutaneous surgery to help urine drain while the kidney heals. A stent must be removed later. Agree before travel whether removal will happen in India or at home.
Sources
General information, not medical or legal advice. Rules change: confirm with the official source. Your treating specialist decides on suitability, treatment and length of stay. How we write and check.