The formation of kidney stones is a very common phenomenon that affects many people around the world. For many people across the globe, stones obstructing the kidney and the ureter, require surgical intervention. Some of the most effective techniques that are minimally invasive for the removal of the stones from the kidney are RIRS (Using the urethra to reach the kidney, removal of the stone) and PCNL (Nephrolithotomy performed via the skin).
Both approaches are effective, although different in their levels of success specifically for the patient, and in many cases, is based on the health of the patient and the size, location, and composition of the stone. This blog gives RIRS vs PCNL comparison which is useful for all the patients out there as they will know which method is good for them.
Understanding RIRS and PCNL
A RIRS vs PCNL comparison needs to focus on how each one is performed. Let’s consider each one separately.
What is the RIRS (Using the urethra to reach the kidney, removal of the stone) procedure?
RIRS is a novel and quite effective approach to performing kidney lithotripsy by endoscopy. The method is used for the removal of small and medium sized stones (from 0 to 2 centimeters) from the kidney. The flexible ureteroscope is put into the urethra, into the bladder and finally to the kidney. A laser (Holmium or Thulium) is used to shred the stones into minuscule dust or fragments that can be easily removed from the body naturally.
RIRS Key Points:
- There is no incision made during the procedure
- It uses a flexible and thin ureteroscope.
- Stone fragmentation is performed through laser technology (Holmium or Thulium).
- Recovery time is reduced.
What are PCNL’s?
Also known as percutaneous nephrolithotomy ,PCNL’s is done on bigger kidney stones (> 2 cm) when other procedures are insufficient. A small back incision is made to put a nephroscope inside the kidney. The stone is shredded by ultrasound or lasers, then removed with a vacuum.
Noteworthy Characteristics of PCNL:
- Suitable for fragmented surgical procedures or extensive stones
- Implantation requires a small incision on the patient’s back
- Ultrasound or laser is used to break stones into smaller pieces
- Eliminating, or clear stone’s remnants is more successful compared to RIRS
Benefits of RIRS
- Headache Free: No opening, this greatly reduces the chances of infection and bleeding
- 82% recommend: Aid everyday within a few days
- Suitable even for: People suffering under kidney issues and bleeding conditions
- No hospital stay is necessary in a lot of instances.
Disadvantages of RIRS
- It might not work for big or a number of stones (may need several treatments).
- Some cases might result in injury or stricture of the ureter.
Advantages of PCNL
- Helpful for big or complicated stones.
- Higher clearance of the stone in a single sitting procedure.
- For hard or staghorn stones, it is the method of choice.
Disadvantages of PCNL
- More difficult due to the need for a cut, which increases the recovery period.
- There is more chance of hemorrhage than RIRS.
- Longer stay at hospital 2-3 days.
When to Choose RIRS Over PCNL?
- On the off chance that you have small to medium-sized stones (≤ 2 cm)
- When a non-invasive approach that does not include an incision is preferred
- If you are a high-risk patient (those who have bleeding disorders or poor kidney function)
- When one desires faster recovery alongside less pain
When PCNL is The Better Choice?
On the off chance that the kidney stone exceeds 2 cm or is staghorn-shaped
When it is resistant to fracturing via laser
When there is an increased need for single sittings stone clearance
Is RIRS Better Than PCNL?
The answer can differ from person to person because it is based on the needs of the individual. People who have smaller stones will need RIRS because it is less invasive and has a faster recovery speed as compared to the others. PCNL remains the gold standard for patients with larger stones because it allows better stone clearance in one sitting.
Conclusion: Expert Opinion Matters
RIRS or PCNL differs for every person depending on the size of the stone, where it is located, what the stone is made up of, and the health of the patient. That is why detailed discussions with an experienced doctor is important to develop the right treatment selection.
Dr. Deepanshu Gupta, who specializes in urology and kidney stones, has treated many patients with advanced RIRS and PCNL procedures. With his extensive experience in minimally invasive urology, he uses the safest and most efficient methods for his patients.
For the best expert care and assistance with kidney stones, contact Dr. Deepanshu Gupta.