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Passing a kidney stone is one of the more memorable kinds of pain a man can experience, and waiting for a stubborn stone to move on its own is not always realistic. When a stone is too large to pass, sits in an awkward spot, or keeps blocking the flow of urine, a urologist may recommend going in and dealing with it directly. Two of the most common ways to do that today are ureteroscopy (URS) and retrograde intrarenal surgery (RIRS).
Both techniques reach the stone through the body's own plumbing, no cut in the skin, and use a laser to break it apart. This guide explains how they work, who they are right for (and who they are not), what happens step by step, how recovery typically unfolds, the real risks, and what the procedure costs in Bangkok compared with the UK and US. Pricing is shown in Thai baht and US dollars so you can plan. As with any stone surgery, none of this replaces a consultation: a urologist needs to review your imaging and confirm the plan before anything is booked.
What ureteroscopy (URS) and RIRS actually are
Both are endoscopic procedures, meaning the surgeon works through a scope rather than through an incision. A thin, flexible (or semi-rigid) instrument is passed up through the urethra and bladder and into the ureter, the tube that carries urine from the kidney down to the bladder. A small camera at the tip lets the urologist see the stone directly on a screen.
The main difference between the two is how far up the urinary tract the surgeon needs to travel:
Ureteroscopy (URS) usually refers to treating stones sitting in the ureter itself, from the lower end near the bladder up toward the kidney. A semi-rigid or flexible scope is often enough.
Retrograde intrarenal surgery (RIRS) uses a fully flexible ureteroscope that is steered all the way up into the kidney's collecting system, so the surgeon can reach stones inside the kidney, including the lower pole, which is a notoriously difficult area to clear.
In practice the line between them blurs, and many urologists use the terms together because the equipment and skills overlap heavily. Once the scope is in position, a holmium laser fibre (or, in newer setups, a thulium fibre laser) is threaded through a working channel and used to either fragment the stone into small pieces that can be removed, or to "dust" it into fine particles that flush out with urine over the following days. Larger fragments are often retrieved with a tiny basket. The European Association of Urology notes that flexible ureteroscopy can be used even for stones larger than 2 cm in experienced, high-volume hands, typically when keyhole surgery through the back (PCNL) or shockwave therapy are not options, and often across more than one session (EAU Guidelines on Urolithiasis).
Kidney stones are common, and men carry more of the risk. The US National Institute of Diabetes and Digestive and Kidney Diseases estimates that about 11% of men and 6% of women will have a kidney stone at some point, and men are more likely to be affected (NIDDK). Having one stone also raises the odds of forming another, which is why prevention matters as much as the procedure itself.
Cost of ureteroscopy and RIRS in Bangkok (2026)
Price is usually the first practical question, so here it is up front. The figures below are indicative ranges for private hospitals and specialist clinics in Bangkok, based on current market research. Your actual quote depends on the hospital tier, the surgeon, whether one or both sides are treated, and how complex the stone is. Always confirm the full breakdown at your consultation.
Item | Bangkok (THB) | Bangkok (USD approx) | Notes |
Ureteroscopy (URS), ureteral stone + laser | 90,000 - 180,000 | 2,800 - 5,600 | Single stone, standard case |
RIRS, kidney stone + laser | 120,000 - 250,000 | 3,750 - 7,800 | Higher for larger or multiple stones |
Double-J stent placement | 20,000 - 60,000 | 625 - 1,875 | Often included; sometimes itemised |
Stent removal (outpatient) | 5,000 - 15,000 | 155 - 470 | Quick clinic procedure 1-2 weeks later |
Pre-op imaging + labs (CT, urine, bloods) | 8,000 - 25,000 | 250 - 780 | Sometimes bundled into a package |
USD conversions use an approximate rate near THB 32 per USD and will shift with the exchange rate. Treat them as a guide, not a fixed price.
How Bangkok compares with the UK and US
This is where medical travel makes financial sense for many men. The same laser stone surgery, done with the same generation of flexible scopes and holmium lasers, costs a fraction of UK or US private fees.
Where | Typical private all-in cost | Notes |
Bangkok | THB 90,000 - 250,000 (USD ~2,800 - 7,800) | Private hospital or specialist clinic, stent often included |
United Kingdom | from about GBP 2,700 (USD ~3,400) and frequently more | Self-pay private ureteroscopy guide price; complex cases and stents add cost (PrivateHealth.co.uk) |
United States | roughly USD 2,800 for the procedure alone, often far higher billed | Mean URS cost in a national analysis; hospital charges and anesthesia can multiply this (World J Urol 2018) |
US "list" charges in particular can run well into five figures once facility fees, anesthesia, and imaging are stacked on, and out-of-pocket exposure depends heavily on insurance. The Bangkok advantage is most striking for men paying privately at home, and for expats and travellers who want the procedure handled quickly without a long public-system wait.
What drives the final price
Several things move your quote within these ranges:
Stone size, number, and hardness. Bigger or multiple stones take longer laser time and may need a staged second session.
One side or both. Bilateral stones treated in one sitting cost more than a single side.
Hospital tier and surgeon. Flagship international hospitals price above mid-tier private hospitals and focused clinics.
Anesthesia type and theatre time. General versus spinal anesthesia, and total operating time, both feed in.
Stent and consumables. The double-J stent, laser fibre, and any single-use scope or basket are real line items.
Length of stay. Same-day discharge is cheaper than an overnight admission.
A transparent clinic will give you an itemised estimate and tell you clearly what is and is not included (anesthesia, pre-op tests, stent, and the follow-up stent removal are the usual things people forget to ask about).
Who URS and RIRS are best for
These procedures are a strong fit for a number of common situations:
Ureteral stones causing pain or blocking urine flow, especially in the mid and lower ureter where shockwave therapy is less reliable.
Lower-pole kidney stones, which drain poorly and often do not clear well after shockwave lithotripsy.
Hard, dense stones (high Hounsfield units on CT) that tend to resist shockwaves but break readily under a holmium laser.
Stones that already failed shockwave lithotripsy (SWL). Direct laser treatment is the logical next step.
Medium-sized stones, roughly in the 1 to 2 cm range, where keyhole surgery through the back (PCNL) would be more invasive than necessary.
Men who cannot have shockwave therapy, for example because of certain anatomy, or because they are on blood thinners that make some other approaches riskier.
A urologist confirms suitability with a CT scan and urine tests, and will weigh stone size, location, density, your kidney anatomy, and your general health before recommending URS or RIRS over the alternatives.
Who it is not for, and contraindications
URS and RIRS are not the right answer for everyone. Be cautious or expect a different plan if any of the following apply:
An active, untreated urinary tract infection. Operating through infected urine risks pushing bacteria into the bloodstream and triggering sepsis. An infection must be cleared with antibiotics first, and the procedure is rescheduled.
Very large stone burden (well over 2 cm or staghorn stones). PCNL usually clears these more efficiently in one go; RIRS may need multiple sessions.
Uncorrected bleeding disorders. Less of a barrier than for keyhole surgery, but still reviewed, and blood-thinning medication is managed in advance with your prescribing doctor.
Anatomy the scope cannot safely reach, such as certain ureteral strictures or reconstructions, or a urinary diversion.
Pregnancy, where laser and imaging choices change and a temporary stent is often preferred until after delivery.
Inability to tolerate anesthesia, which the anesthetist assesses case by case.
This is exactly why the procedure is prescription-only and gated behind a proper consultation. It is not something to self-select into from a price list.
Step by step: what happens on the day
Knowing the sequence tends to take the edge off the nerves.
Admission and prep. You arrive fasted. The team confirms your imaging, consent, and any medication adjustments. An IV line goes in.
Anesthesia. Most men have general anesthesia, so you are fully asleep; spinal anesthesia is an alternative in some cases. You will not feel the procedure.
Reaching the stone. The urologist passes the scope through the urethra, bladder, and up the ureter, watching on a screen. For RIRS, the flexible scope is steered into the kidney. A thin guidewire and sometimes a soft access sheath help protect the ureter.
Laser treatment. The holmium (or thulium) laser fibre fragments or dusts the stone. The surgeon clears pieces with a basket as needed and inspects the area to confirm the stone is gone.
Stent placement. A soft double-J stent is often left in the ureter to keep it open and let any swelling settle. It sits with one curl in the kidney and one in the bladder, and it is removed later.
Recovery and discharge. You wake in recovery. Many men go home the same day; some stay one night, particularly after a longer RIRS or a bilateral case. The whole operation commonly takes 30 to 90 minutes depending on the stone.
Recovery, stage by stage
Recovery from URS and RIRS is generally quick because nothing was cut, but the stent (if you have one) shapes how the first couple of weeks feel.
Day 0 (procedure day). Mild grogginess from anesthesia. You can usually eat, drink, and walk the same day. Expect to be told to drink plenty of water to help flush stone dust.
Days 1 to 3. Pink or lightly blood-tinged urine is normal and clears with fluids. You may feel a burning sensation when you pass urine, an urge to go more often, and some flank twinges, especially if a stent is in place. Prescribed pain relief handles most of this. Many men with desk jobs feel able to work within a few days, though it is sensible to take it easy.
Week 1 to 2. Stent-related symptoms are the main story here. The stent can cause a frequent need to urinate, a feeling of not quite emptying, mild flank discomfort when you pee, and occasional spotting of blood. This is common and expected, not a sign something went wrong. The stent is usually removed in a short outpatient procedure around 1 to 2 weeks after surgery, and most men feel markedly better within a day of removal.
Week 2 to 4. With the stent out, normal activities and light exercise typically resume. Your urologist may recommend continued high fluid intake and, depending on the stone analysis, dietary changes to lower the chance of forming another.
Week 4 to 6. Most men are back to full activity, including heavier exercise, once healing is confirmed. A follow-up scan or ultrasound may be arranged to check the kidney is clear.
A practical heads-up on stents: research using the validated Ureteral Stent Symptom Questionnaire found that urinary symptoms reduce quality of life in up to 80% of patients while a stent is in place, with around 78% reporting bothersome urinary symptoms (Joshi et al., J Urol). The encouraging part is that these symptoms are temporary and resolve once the stent comes out.
How well it works
Results are good and well documented, which is part of why URS and RIRS have become first-line for so many stones.
In a large single-centre series of flexible ureterorenoscopy, the stone-free rate was about 80.9% on day one and 91.5% at one month, with complications described as low-grade and no patient needing a transfusion (Cureus, 2022).
A prospective multicentre European study reported a stone-free rate of 73.6% after a single procedure, rising to 78.9% after a second session, with an overall complication rate of 15.1% and no major ureteral injuries (Int Braz J Urol, 2016).
Compared head to head with shockwave lithotripsy, ureteroscopy cleared more stones first time, 84% versus 60%, and at lower overall cost in a meta-analysis of 12 studies and over 2,000 patients (World J Urol, 2018).
Two takeaways for planning: first, success is high but not guaranteed in one go, and a minority of men need a second session to finish the job, particularly with large or multiple stones. Second, outcomes depend heavily on the surgeon's volume and equipment, which is why where you have it done matters.
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Risks and side effects
URS and RIRS are considered safe, and serious problems are uncommon, but no procedure is risk-free. Knowing what is normal versus what needs urgent attention is the useful part.
Common and usually temporary:
Blood in the urine (hematuria) for a few days
Burning or stinging when passing urine
Frequent urge to urinate and a feeling of incomplete emptying, mostly from the stent
Mild flank or bladder discomfort
Some residual stone dust passing over the following days
Less common:
Urinary tract infection needing antibiotics
Temporary swelling of the ureter
Residual fragments large enough to need a further procedure
Ureteral injury; minor wall abrasions occur in a small percentage and major injuries are rare (Int Braz J Urol, 2016)
Narrowing (stricture) of the ureter over the longer term, which is uncommon
Seek urgent medical care if you have:
A fever above 38°C, shaking chills, or feeling generally very unwell, which can signal infection spreading to the bloodstream and is an emergency
Heavy bleeding, or passing large clots, or urine that stays deep red
Inability to pass urine at all
Severe pain that your prescribed medication does not control
Persistent vomiting that stops you keeping fluids down
Do not wait these out. A urinary infection after stone surgery can escalate quickly, so prompt assessment is the safe choice.
How URS and RIRS compare with other stone treatments
Choosing the right tool depends mostly on stone size, location, and hardness. This table summarises the main options.
URS / RIRS | Shockwave lithotripsy (SWL) | PCNL (keyhole via back) | Medical / watchful waiting | |
How it works | Scope through urinary tract, laser breaks stone | Shockwaves from outside the body break the stone | Small incision in the back into the kidney | Fluids, medication, time for small stones to pass |
Best for | Ureteral, lower-pole, and hard stones; ~1-2 cm | Smaller (<1.5 cm), softer, upper/mid kidney stones | Large or staghorn stones (>2 cm) | Small stones (<5-6 mm) likely to pass |
Incision | None | None | Small skin incision | None |
Stone-free in one session | High, especially focused stones | Lower, may need repeat sessions | Highest for large stones | Depends on stone passing |
Typical recovery | Same day to 1 night; stent 1-2 weeks | Outpatient, may repeat | Longer; hospital stay | No procedure |
Direct view of stone | Yes | No | Yes | n/a |
There is no single best procedure, only the best match for your stone. A good urologist will sometimes recommend the less obvious option, and being told you do not need surgery at all is a perfectly good outcome.
Choosing a safe clinic in Bangkok
Bangkok has genuine depth in urology, but quality varies, and stone surgery rewards experience. Use these checks:
Surgeon volume and credentials. Ask how many flexible ureteroscopy and RIRS cases the urologist performs each year. High-volume operators have better stone-free rates and fewer complications. Confirm board certification in urology.
Modern equipment. Look for current-generation flexible ureteroscopes (single-use or well-maintained reusable scopes) and a holmium or thulium fibre laser. Older or poorly maintained kit limits what can be treated safely.
A transparent, itemised quote. You should see, in writing, what the price covers: surgeon fee, anesthesia, stent, consumables, hospital stay, and the follow-up stent removal. Vague all-in numbers that balloon later are a red flag.
Proper pre-op workup. A serious clinic insists on a CT scan and urine culture before booking, and treats any infection first. A clinic willing to skip this is cutting a dangerous corner.
Clear follow-up plan. Stent removal timing, who to call after hours, and what to do if you develop a fever should all be spelled out before you go home.
English-language care and aftercare for travellers. If you are coming from abroad, confirm post-discharge support and how stent removal will be handled around your travel dates.
Red flags to walk away from: pressure to decide on the spot, no named surgeon, no written breakdown, reluctance to order pre-op imaging, or prices that look too good to be true for a fully equipped theatre and an experienced team.
Where Menscape fits
Menscape is a men's-health clinic in Bangkok, and our urology pathway focuses on clear, unhurried guidance for stone disease, from working out whether you even need surgery to arranging the right procedure with experienced urologists and current laser technology. We aim to be straight with you about expected outcomes, the role of a stent, and the total cost, including the parts people often forget to ask about. Treatment is always preceded by a consultation and the appropriate imaging, because the right plan depends on your specific stone and anatomy, not a generic package.
Book a consultation
If you are dealing with a kidney or ureteral stone and want to understand whether ureteroscopy or RIRS is right for you, the next step is a consultation. A urologist will review your scans, confirm the diagnosis, explain your options in plain language, and give you a transparent, itemised quote. Book a consultation with Menscape in Bangkok to get a personalised assessment and treatment plan.
*This article is for general information and does not replace individual medical advice. Ureteroscopy and RIRS are surgical procedures that require an in-person consultation, imaging, and a urologist's prescription. Pricing is indicative and should be confirmed at your consultation.*
Frequently Asked Questions
Is ureteroscopy or RIRS painful?
You feel nothing during the procedure because it is done under general or spinal anesthesia. Afterwards, most men have mild discomfort: some burning when passing urine, a frequent urge to go, and pink-tinged urine for a few days. If a double-J stent is left in place, that is usually the main source of nuisance until it is removed, typically 1 to 2 weeks later. Prescribed pain relief manages the early symptoms well.
How long does recovery take?
Most men go home the same day or after one night. Light activities and desk work are often possible within a few days. The biggest factor is the stent: while it is in, you may have urinary frequency and mild flank discomfort, which settle quickly once it is removed at around 1 to 2 weeks. Full activity, including heavier exercise, usually resumes by 4 to 6 weeks once healing is confirmed.
Why do I need a stent, and does it have to stay long?
A double-J stent keeps the ureter open and lets any swelling settle after the stone is treated, which lowers the risk of blockage. It is not always required, but it is common. When used, it usually stays for about 1 to 2 weeks and is taken out in a short outpatient procedure. Most men feel noticeably better within a day of removal.
What is the difference between URS and RIRS?
They use the same family of equipment and skills. Ureteroscopy (URS) generally treats stones in the ureter, the tube between the kidney and bladder. RIRS (retrograde intrarenal surgery) uses a fully flexible scope steered up into the kidney itself to reach stones inside it, including the hard-to-clear lower pole. Many urologists use the terms together because the procedures overlap so heavily.
How much does ureteroscopy or RIRS cost in Bangkok?
As an indicative guide, private hospitals and specialist clinics in Bangkok charge roughly THB 90,000 to 250,000 (about USD 2,800 to 7,800) all-in, depending on the hospital tier, the surgeon, stone size and number, and whether a stent and overnight stay are included. That is generally well below typical UK or US private fees for the same laser surgery. Always confirm an itemised quote at your consultation.
What is the success rate?
Stone-free rates are high. Published series report roughly 80% to 90% of patients clear after flexible ureteroscopy, with figures around 80.9% on day one and 91.5% at one month in one large series. Ureteroscopy also clears more stones first time than shockwave lithotripsy (about 84% versus 60% in a meta-analysis). A minority of men, usually those with large or multiple stones, need a second session to finish the job.
Can these procedures treat large kidney stones?
They are ideal for small to medium stones, roughly 1 to 2 cm, and for hard or lower-pole stones. For very large stones (well over 2 cm) or staghorn stones, percutaneous nephrolithotomy (PCNL) usually clears them more efficiently in one session. That said, the EAU guidelines note RIRS can be used for larger stones in experienced, high-volume hands, sometimes across more than one session. Your urologist will advise based on your CT scan.
What warning signs mean I should seek urgent care after the procedure?
Get urgent medical attention if you develop a fever above 38°C, shaking chills, or feel very unwell, as this can signal a urinary infection spreading to the bloodstream. Also seek help for heavy bleeding or large clots, an inability to pass urine, severe pain that your medication does not control, or persistent vomiting. Some pink urine and mild discomfort are normal, but these red-flag symptoms are not and need prompt assessment.
Will I need to change anything to avoid another stone?
Quite possibly. Having one stone raises the risk of forming another, so your urologist may recommend higher daily fluid intake and, based on the chemical analysis of your stone, specific dietary adjustments or medication. Men are more prone to stones than women, so for many it is worth treating the underlying tendency, not just the current stone.
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