PCNL Vs RIRS – Which Surgery is Better for Kidney Stone Removal? : Hello everyone, now if you have ever had kidney stone and been to a urologist, I am sure you have heard these names “PCNL” and “RIRS”. Both these are names for surgeries or procedures used for kidney stone removal. RIRS (Retrograde Intrarenal surgery) is comparatively a newer technique as compared to PCNL (Percutaneous Nephrolithotomy)
I want to be precise and at the same time I want to convey maximum information regarding these two procedures. Hence, instead of using paragraphs, I will list out the important differences between the two.
| S. No. | Criteria/Procedure Name | PCNL | RIRS |
| 1. | Full Name | PerCutaneous NephroLithotomy | Retrograde Intra-Renal Surgery |
| 2. | Cuts on Body | Small hole is made in the back (lumbar region) and on the kidney for this surgery. | No cuts or incisions are made anywhere on the body. No cuts or incisions on the kidney. |
| 3. | Stone Size | PCNL is preferred for large to very large kidney stones usually >2 cm in sizes. | RIRS is suitable for smaller stones usually <2 cm in sizes. |
| 4. | Bleeding | There is some amount of controlled blood loss. Experienced urologists are trained to minimize this. | There is no blood loss from the body in RIRS as there are zero incisions made anywhere. |
| 5. | Patients taking blood thinners (anti-coagulants) | Patients undergoing PCNL need to stop taking blood thinners 3 to 5 days before surgery | Patients who are going for RIRS need not stop taking blood thinners (like ecosprin 75g) before the surgery. But stronger blood thinners need to stopped 3-5 days before surgery. |
| 6. | Hospital Stay Time & Recovery Time | 2-3 days hospital stay time. Recovery time is short but more than RIRS. | 1 day hospital stay time. Recovery time is fastest with RIRS. |
| 7. | Renal failure | PCNL is not preferred in patients with chronic renal failure. | RIRS can be safely done is patients of chronic renal failure |
| 8. | Stone Type | PCNL is more effective in removing hard stones in the kidney. | For large hard stones, patient may need more than one RIRS session. |
| 9. | Chances of Residual Stones | Chances of residual stone is less in case of PCNL | Chances of residual stone is low and yet slightly higher than PCNL. |
| 10. | Ectopic & Anomalous Kidney Patients (Kidney located lower in abdomen or horseshoe kidney) | PCNL can be done in such patients but they may need some special precaution additional procedures like laproscopy assisted PCNL. | RIRS can be extremely difficult in crossed fused ectopia (where both kidneys are on same side) or horseshoe kidney because of structural abnormalities. |
| 11. | Equipment | PCNL equipments are not as expensive as RIRS instruments | RIRS instruments and gadgets are extremely expensive. |
So as you can see, both PCNL and RIRS procedures have there own pros and cons list. As a general rule, it should be remembered that
- PCNL is preferred if the stone is larger than 2 cm in size.
- RIRS is preferred in smaller stones.
At Institute of Urology, Jaipur, out motto is to use least invasive techniques. Therefore we always carefully examine the patients and analyse everything before making a decision which is best suitable for the fast and long recovery of the patient.
We are proud to say that we have some of the most advanced and modern equipments from around the world and therefore we are able to provide the best possible surgical outcomes to the best of our abilities.
At the end, I want to stress on the fact that whenever you are suffering from stone disease of the kidney, it is utmost important to meet the urologist and then make an informed decision about the procedure you would want to go for. For any further help or assistance, you can always call us on 8601539297 (Dr. Rajan Bansal) or book an online appointment as well 9829013468. Thank you.
