When you’re trying to get rid of stones in the kidneys you’re probably looking to get rid of the stones as fast as possible. For those patients considering surgery and researching URS and RIRS I’m here to help you understand it better so you can communicate better with your physician and receive the best answer for your condition.
What Are URS and RIRS?
Let’s start with URS. This is short for Ureteroscopy. Ureteroscopy is an invasive technique used for removing stones in the ureter which is The ureter is the tube that carries urine from your kidneys to the bladder. A small scope is inserted into the urinary tract, the position of the stone is located then a laser or an alternate tool can break the stone or remove it.
Then there’s RIRS, or Retrograde Intrarenal Surgery. You can think of this as the “deep-into-the-kidney” cousin of URS. With RIRS, a flexible scope is advanced all the way into the kidney’s collecting system, or renal pelvis and calyces, to be able to treat stones that are within the kidney-not just in the ureter. It’s still minimally invasive, with no big cuts, but technically a little more advanced.
How the procedures work – step by step
For URS:
Under anaesthesia, spinal or general, a ureteroscope is introduced via the urethra → bladder → into the ureter.
The surgeon locates the stone, uses a laser fibre to fragment it, or grasps it with a basket.
Sometimes afterwards, a small stent is placed to keep the ureter open while recovery takes place.
You will probably stay in hospital for a short time, then go home.
For RIRS:
Similar access path, but the scope travels further into the kidney (urethra → bladder → ureter)
A flexible scope negotiates the renal pelvis/calyces. The laser breaks the stone into tiny pieces, which can either be removed or allowed to pass naturally.
A stent is almost always placed to ensure urine drainage and healing.
Recovery is still quick compared to open surgery, but the procedure may take a bit longer and requires specialized equipment and skill.
Head-to-head: Key differences at a glance
Here’s a simple table to help compare URS vs RIRS:
| Feature | URS (Ureteroscopy) | RIRS (Retrograde Intrarenal Surgery) |
| Primary target area | Ureter (or lower ureter/near bladder) | Inside the kidney (renal pelvis, calyces) |
| Scope type / access | Rigid or semi-rigid ureteroscope → ureter | Flexible ureteroscope → deeper kidney areas |
| Stone size/complexity best suited | Stones in ureter, moderate size | Stones inside kidney, possibly multiple or anatomically tricky |
| Invasiveness & recovery | Minimally invasive; fast recovery | Also minimally invasive; slightly more complex access |
| Hospital stay / downtime | Often 1 night or day-care, return to activities in days | Similar short stay, but may require slightly more recovery time |
| When preferred | Ureteric stones, accessible location | Intrarenal stones, complex anatomy, stones that other methods failed |
| Risks / technical demand | Standard endoscopic risks | Higher technical demand; deeper access means slightly higher challenge |
When to choose URS vs RIRS: what the decision depends on.
Location, size/complexity, and overall health-and what your urologist sees on imaging-really are the three variables that determine this decision.
URS often makes sense if a stone is stuck in the ureter (especially middle or lower ureter) and accessible.
If you have kidney stones (in the renal pelvis or calyces), especially multiple or other treatments, such as shock-wave lithotripsy have failed, then RIRS is often a better fit.
This also depends on your surgeon’s experience, the available technology and your general condition. In short: URS = great for ureter, RIRS = ideal for inside-kidney stones.
What recovery, risks & lifestyle look like
The good news is that both URS and RIRS are minimally invasive, meaning no large cuts, faster recovery and less pain, compared to the older open surgeries. Most patients are up and walking the same evening, go home in 1-2 days and resume normal activities within a week or so.
However, some things to keep in mind:
You may have a temporary stent inside the urinary tract-for a few days to weeks-which may cause mild discomfort, frequent urination or some blood in the urine.
You may have some burning when you urinate for a little while.
As with any procedure, there is a small risk of infection, bleeding, ureteral injury (rare) or incomplete stone clearance especially if anatomy is complex.
Aftercare: Fluid intake to help flush out the fragments, adhering to advice from the surgeon regarding activity and dietary changes along with proper hydration in order to minimize the chance of forming stones in the future.
Dr. Deepanshu’s Final Take: Finding Your Smoothest Path to a Stone-Free Life
To sum it up, both URS and RIRS are excellent contemporary options for the treatment of a kidney stone. These platforms guarantee minimal invasiveness, fast recovery and very good results at the hands of an experienced expert. The best one for you would depend upon the stone’s site and size, your anatomy,and your health.
URS is fantastic when a stone is situated in the ureter. RIRS steps in when stones are inside the kidney or when access is trickier. Knowing the difference, asking the right questions and having a skilled surgeon like Dr. Deepanshu are all you really need to rid yourself of that pesky kidney stone and get back to your normal life with peace of mind. Smooth recovery and stone-free days ahead!