RIRS Retrograde Renal Surgery in Singapore
Retrograde Intrarenal Surgery (RIRS) is a minimally invasive procedure used to treat kidney stones using a flexible ureteroscope inserted through the urinary tract. It allows for precise stone fragmentation using laser energy without the need for any incisions.
Medically reviewed by Dr Ho Siew Hong
Senior Consultant Urologist
MBBS (NUS), FRCS (Edinburgh, Glasgow), FAMS (Urology), Singapore Board Certified Urologist
RIRS involves the insertion of a thin, flexible scope through the urethra, bladder, and up the ureter into the kidney. A laser fibre is used to break kidney stones of any size into fine dust or fragments that can be removed or pass naturally. This approach avoids cuts and promotes quicker recovery.
RIRS retrograde renal surgery may be suitable for patients with:
- Kidney stones up to 3 cm in size
- Stones in difficult-to-access areas of the kidney such as the lower pole
- Failed ESWL (shock wave therapy)
- Bleeding disorders or high surgical risk (avoids open surgery)
- General anaesthesia is administered
- A guidewire is placed into the urinary tract in to the kidney under xray guidance
- An ureteric access sheath is placed to prevent injury to the ureter
- A flexible ureteroscope is passed through the sheath into the kidney
- Stones are visualised and fragmented using a high power Thullium laser
- Stone fragments are actively suctioned out via the access sheath
- A temporary stent is placed to ensure drainage
- No incisions required
- Safe and effective for complex stone locations and large stones
- Minimal bleeding and low complication rate
- High probability of complete stones removal
- Suitable for patients unfit for open or percutaneous surgery
- Quick recovery and resumption of normal activities
- Day surgery or overnight stay
- Resume normal activity within 3–5 days
- Stent removal after 1–2 weeks if inserted
- Hydration encouraged to flush out stone fragments
- Follow-up imaging to ensure stone clearance
As with any surgery, there are potential risks, including:
- Urinary tract infection
- Ureteral injury or stricture
- Incomplete stone clearance (may require repeat procedure)
- Stent-related discomfort
Book a Consultation
If you are experiencing kidney stone symptoms or have been advised to consider surgery, consult Dr Ho Siew Hong for a personalised treatment plan.
Frequently Asked Questions
It is generally well-tolerated under anaesthesia, with minimal post-op discomfort.
Primary RIRS refers to performing RIRS without prior need to undergo an initial separate procedure to insert a stent. With modern finer scopes, may RIRS can be done as a primary procedure.
It is usually done in stages, one kidney at a time.
Large or multiple stones may need staged procedures.
Most patients resume normal activities within a few days.
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