Ureteroscopy and RIRS · Endoscopic Kidney Stone Surgery in Bangkok

URS (Ureteroscopy) refers to a minimally invasive, scope-based treatment specifically for stones located in your ureter, the tube connecting your kidney to your bladder. RIRS (Retrograde Intrarenal Surgery) uses the same flexible ureteroscope and laser technology but allows the surgeon to navigate further, reaching up into the kidney itself to treat stones. The core difference is the anatomical target · URS addresses ureteric stones, while RIRS treats kidney stones. Both procedures offer precise stone fragmentation and removal.

URS/RIRS is often preferred for specific stone characteristics. It's highly effective for hard stones, typically those with Hounsfield units above 1000, or stones located in your lower ureter or lower kidney pole where ESWL has reduced efficacy. If you have larger stones, generally over 2 cm, or if ESWL has already failed to fragment your stone adequately after one or two sessions, your urologist may recommend URS/RIRS for its higher success rates and direct stone removal.

A double-J ureteric stent is a thin, flexible tube placed temporarily to keep your ureter open. This prevents swelling and ensures urine drainage while your ureter heals from the stone passage or the scope's presence. It helps reduce post-operative pain and the risk of complications like kidney blockage. Most patients have the stent removed in a brief, 5-10 minute clinic procedure 1-2 weeks later. In some cases, particularly for smaller stones or uncomplicated procedures, you may not require a stent at all.

Most patients experience a relatively quick recovery, often returning to light normal activities within 1-2 days. You might feel some mild discomfort or urinary frequency, especially if a stent is in place. This sensation typically subsides once the stent is removed, usually within 1-2 weeks. We advise avoiding strenuous exercise or heavy lifting for about a week to allow your body to fully heal. Your urologist will provide specific post-operative instructions.

The cost of URS/RIRS in Bangkok can vary based on several factors unique to your situation. These include the size and number of your stones (stone burden), the type of anesthesia you choose, whether a flexible or rigid scope is required, and if a ureteric stent needs to be placed. For an accurate and personalized quote tailored to your specific needs, we highly recommend booking a consultation with our urologist.

URS/RIRS boasts high success rates, often achieving stone-free rates of 85-95% in a single procedure, depending on stone size and location. For larger or more complex stones, multiple sessions might be needed. The long-term outcomes are excellent, with a low recurrence rate if you adhere to preventative measures like dietary changes and increased fluid intake. Your urologist will discuss your specific prognosis and strategies to minimize future stone formation.

For your comfort and safety during URS/RIRS, various anesthesia options are available. Most commonly, the procedure is performed under general anesthesia, meaning you'll be completely asleep. Alternatively, regional anesthesia such as spinal anesthesia, which numbs the lower half of your body, can be used. Your anesthesiologist will discuss your medical history and the specifics of your procedure to recommend the safest and most appropriate option for you, ensuring a pain-free experience.

During your consultation, you'll meet with our experienced urologist to discuss your medical history and symptoms. We'll review your existing imaging, such as CT scans or ultrasounds. If you don't have recent imaging, we may perform an ultrasound or order a CT scan. The urologist will explain your stone condition, discuss treatment options like URS/RIRS, and answer all your questions. Together, you'll decide on the best treatment plan for your specific needs.

International patients should plan to arrive in Bangkok a few days before their procedure for pre-operative assessments. The hospital stay is typically 1-2 days. If a stent is placed, you'll need to stay for its removal, usually 1-2 weeks post-procedure. We can facilitate follow-up consultations via secure WhatsApp video calls if you need to return home sooner. You can generally fly home safely 2-3 days after stent removal, or 5-7 days post-procedure if no stent was placed.