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Kidney stone removal addresses stones that form when minerals and salts in urine crystallize within the kidney, causing pain, blood in urine, infection, or blockage of urine flow when conservative measures such as hydration and medication fail to clear them. Percutaneous nephrolithotomy, or PCNL, is used for larger or more complex stones and involves creating a small tunnel through the skin of the back directly into the kidney under X-ray or ultrasound guidance, through which a scope and instruments break up and remove the stone in fragments. Retrograde intrarenal surgery, or RIRS, is a scarless alternative for small to medium stones in which a flexible scope is passed through the urinary tract via the bladder and ureter up into the kidney, where a laser fragments the stone into pieces small enough to pass or be extracted. Both procedures are performed under spinal or general anesthesia, with PCNL generally taking one to two hours and RIRS somewhat less. Indian urology centers perform very high volumes of both techniques, often supported by advanced laser lithotripsy systems. Recovery from RIRS is typically quicker with a shorter hospital stay, while PCNL patients usually need a few additional days to recover, with a stent often left temporarily to support healing.
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